A Prospective, Non-Randomized, Evaluation of Low-Risk Patients Undergoing Carotid Stenting With ANgiomax (Bivalirudin)

Inclusion Criteria: * Patient (male or non-pregnant female)must be \> than or= 18 * Qualifying non-invasive test (ultrasound or MRA) was performed less than 60 days prior to study entry. Carotid duplex study revealed: * Stenosis \> or = to 50% in symptomatic patients * Stenosis \> or = to 60% in asymptomatic patients * Target lesion may be in the common or internal carotid artery and is amenable to treatment with angioplasty and stenting * Patients taking warfarin may be included if their dosage is reduced before the procedure to result in an INR of 1.5 or less and a Prothrombin time of 15 seconds. Warfarin may be started after the procedure. * Female patients of childbearing potential must have a documented negative pregnancy test during index hospitalization * Patient or legally authorized representative must sign a written informed consent, prior to the procedure, using a form that is approved by the local institutional review board or medical ethics committee Exclusion Criteria: (Patients will be excluded from the study if ANY of the following conditions are present) * There is total occlusion of the target carotid artery treatment site. * The patient has an allergy or contraindication to aspirin, ticlopidine, clopidogrel, bivalirudin, nickel, titanium, or a sensitivity to contrast media, which cannot adequately pre-medicated. * The subject has a platlet count\< 100,000 cells/mm3 or 700,000 cells/mm3 or a WBC of \< 3,000 cells/mm3. * Stroke within 7 days prior to the procedure * NIH stroke score \> or = to 15 within 7 days prior to the procedure * The patient has experienced a significant GI bleed within 6 months prior to study procedure * The patient has active internal bleeding * The patient has had major surgery or serious trauma within 6 weeks before enrollment * The patient has excessive peripheral vascular disease that precludes safe sheath insertion * The patient has had an intracranial hemorrhage, hemorrhagic stroke, major stroke or any stroke within one week of index procedure * The patient has concurrent emboligenic cardiovascular disease not adequately treated with anticoagulant therapy * The patient is on renal dialysis * The patient has had low molecular weight heparin (LMWH) administered within 8 hours or less, prior to the procedure * Severe hypertension not adequately controlled by antihypertensive therapy at the time of study entry(BP\> 180/110mmHG) * The patient is unable or unwilling to cooperate with the study follow-up procedures