What are the key factors in setting up a successful carotid stent program?

Carotid stenting will drastically alter the management of carotid bifurcation stenosis. Key factors to include when initiating a carotid stent program are discussed. Questions addressed include the following: Who has clinical responsibility for patients with carotid disease? What is the rationale for a carotid stent program? How does one initiate a carotid stent program? How does one deal with endovascular realities? Training, patient selection, quality improvement, and proctoring are also reviewed.