Carotid artery stenting (CAS) is nowadays considered a less-invasive alternative to carotid endarterectomy (CEA) for the treatment of symptomatic and asymptomatic patients with carotid artery stenosis. CAS still presents a higher rate of periprocedural stroke compared to CEA in symptomatic patients in RCTs ( ) and even if the long-term outcome is similar between the two treatments, the outcome continues to favor CEA ( ).