ABSTRACT
Carotid stenting is a safe alternative option to conventional carotid endarterectomy
in the treatment of carotid artery stenosis in patients considered poor candidates
for surgery or who choose not to have open surgery. During the stenting procedure,
however, distal embolization may occur with neurological sequelae. To reduce the incidence
of this, several cerebral-protection devices (CPDs) have been developed. Different
types of CPDs are now commercially available: distal occlusion balloons, distal filters,
and proximal protection devices with or without reversal of flow. But complications
can occur with their use and are usually associated with an inability to cross the
lesion, failure to capture the emboli, vasospasm, and vessel wall injury. Because
protection devices are currently the focus of interest by manufacturers and physicians,
several trials are going on worldwide to analyze the characteristics of each of them
and to evaluate their efficacy in reducing the rate of distal embolization.
KEYWORDS
Cerebral embolization - balloon occlusion - filters - flow reversal
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Fabrizio FanelliM.D.
Department of Radiological Sciences, Interventional Radiology Unit, University of
Rome “La Sapienza”
324 Viale Regina Elena, 00161 Rome, Italy