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. Author manuscript; available in PMC: 2010 Apr 1.
Published in final edited form as: Stroke. 2009 Feb 10;40(4):1140–1147. doi: 10.1161/STROKEAHA.108.541847

Table 1.

Protocol for carotid artery stent procedure in CREST

• Preprocedural (48 hours): oral aspirin (325 mg once or twice daily) and oral clopidogrel (75 mg twice daily). Ticlopidine (250 mg twice daily) substituted if patient was unable to tolerate clopidogrel.
• Transfemoral approach.
• Heparinization to activated clotting time of 250–300 (with introduction of anti-embolic device)
• 5F catheter for cannulation of aortic arch branches.
• 0.035in. (coated Terumo) long-exchange guidewire to external carotid artery.
• 6F guide sheath (100 cm length) to common carotid artery proximal to lesion; occasional use of the 0.035 in.
• 0.014in guidewire to cross common-internal carotid stenosis, and place an anti-embolic device (ACCUNETTM or RX ACCUNETTM (Abbott Vascular, Abbott Park, Illinois); 3 or 4 mm low profile balloon for pre-deployment dilatation as required.
• 1 mg of atropine administered IV prior to the first balloon dilatation - either pre-deployment or post-stent.
• Deployment of a nitinol self-expanding stent (ACCULINKTM or RX ACCULINKTM (Abbott Vascular, Abbott Park, Illinois).
• Post-stent dilatation using 5.0 – 5.5 mm balloons.
• Intermittent hand-injection angiography during procedure; utilizing bony landmarks for balloon and stent placements.
• Use of femoral closure device as recommend by individual interventionalists; aspirin was continued indefinitely while clopidogrel (or ticlopidine) was continued for a minimum of 2–4 weeks after CAS.