Carotid artery stenting (CAS) is the endovascular alternative to endarterectomy for internal carotid stenosis selected for revascularisation, symptomatic or asymptomatic. A self-expanding stent is placed across the bifurcation under embolic protection, reached through the femoral or radial artery or, in transcarotid artery revascularisation (TCAR), through the common carotid artery under flow reversal. Selection rests on the patient's procedural risk and on the anatomy of the aortic arch, the lesion and the neck on CT angiography (CTA), which together show whether stenting is suitable and by which route. The procedure is done under dual antiplatelet therapy, with prevention of bradycardia and hypotension during balloon inflation and observation for cerebral hyperperfusion afterwards. Heavily calcified lesions and irradiated or otherwise hostile necks need particular planning.