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Carotid angioplasty-stenting (CAS) was attempted in 78 carotid arteries in 74 patients (45 men and 29 women) with occlusive internal carotid arterial disease and was technically successful in 77 of 78 arteries (99%). Of 77 arteries with successful CAS, 58 (75%) were asymptomatic, 15 (20%) were associated with transient ischemic attacks or amaurosis, and 4 (5%) were associated with prior stroke. Of 77 arteries with successful CAS, 34 (44%) were associated with prior carotid endarterectomy with recurrence of occlusive carotid disease, and 43 arteries (56%) were associated with primary CAS. Sixty-eight of 74 patients (92%) who underwent CAS had high-risk features. Cerebral protection was given to 22 of 74 patients (30%). None of the 74 patients (0%) died of CAS. Minor stroke developed in 3 of 74 patients (4%). These data show that CAS is effective for treating symptomatic and asymptomatic patients with occlusive carotid arterial disease.