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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
CAROTID ARTERY DISEASE
Italian Journal of Vascular and Endovascular Surgery 2006 September;13(3):125-30
Embolic protection devices
Bosiers M., Deloose K., Verbist J., Peeters P.
Department of Vascular Surgery AZ St-Blasius, Dendermonde, Belgium
Department of Cardiovascular and Thoracic Imelda Hospital, Bonheiden, Belgium
The importance of cerebral protection during carotid artery stenting (CAS) cannot be underestimated. To date, 3 different techniques have been developed to secure CAS from neurological complications. These are defined as: distal occlusion devices, distal filter devices and proximal occlusion devices. All cerebral protection devices have proven to safely capture and remove possible debris during the different procedural steps in order to prevent any embolization to the cerebral circulation. Nevertheless, none of the devices can guarantee a complete emboli-free procedure, as any supra-aortic endovascular manipulation (e.g. a simple diagnostic carotid angiography) contains a certain risk on cerebral emboli migration. Since all devices have their assets and downsides, it is virtually impossible to acclaim one specific device as being the best, but adequately device selection can help avoiding neurological complications.