Aims: The aim of this study was to propose new anatomical-procedural classification systems for evaluating carotid lesions and carotid artery stenting (CAS).
Methods and results: The methodology used to propose new concepts to be applied in the carotid district was based on three steps: 1) research in PubMed with the terms “carotid artery” (CA) plus “classification” was performed in August 2010 to verify the existence of any classification system for the CA that could be applied for evaluating CAS; 2) formulation of the “stenting segment” concept and elaboration of two classification systems - (a) the “ABC” system for classifying carotid lesions according to their location, and (b) the “five arterial zones” system for identifying specific arterial zones of the CA concerning the basics steps of CAS; and 3) retrospective testing of the applicability of these classification systems on two hundred and fifty consecutive CA angiograms, in which an obstructive lesion was identified. It was possible to delimit the “stenting segment”, to classify the carotid lesions according to the “ABC” classification system and to identify the arterial zones according to the “five arterial zones” classification system in all (100%) CA angiograms studied.
Conclusions: The “ABC” and the “five arterial zones” anatomical-procedural classification systems are applicable in patients with obstructive disease of the extracranial CA. These systems may contribute to the standardisation of CAS technical evaluation.