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Online ISSN 1827-1847
Coppi G., Moratto R.
Department of Vascular Surgery Policlinico Hospital of Modena University of Modena and Reggio Emilia Modena and Reggio Emilia, Italy
The diffusion of carotid artery stenting (CAS) is prevented by the risk of embolization in every phase of the procedure. The introduction of the cerebral protection system led to the achievement of successful outcomes, comparable to those of surgical procedures. A large variety of protection systems are available, the most used of which are those with filters and proximal occlusion systems with double balloons. Each of these devices has advantages and disadvantages depending on the patient’s anatomical features. The literature has not yet demonstrated in statistical terms the effectiveness of one device over another even if, in difficult anatomical features, the devices with a double balloon system seem to lead to a better outcome. The use of cerebral protection devices cannot entirely prevent the onset of embolic complications during CAS, therefore, it should be evaluated bearing in mind not only the characteristics of the patient, but also the selection of the lesions, the imaging equipment and the level of expertise and unity of the whole medical team.