ADVANCES IN CAROTID ARTERY STENTING 

The Journal of Cardiovascular Surgery 2013 February;54(1):33-9

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Carotid artery stenting with filters

Mathias K. ✉

Department of Radiology, Klinikum Dortmund, Dortmund, Germany

Filters are a valuable aid for safe carotid artery stenting, but require good knowledge of their function, and their shortcomings. Filters capture visible particles in 5-20% and microscopically in about 70% of the cases. Transcranial Doppler ultrasound and diffusion weighted MRI investigations have shown that particles are released during filter placement and also during the next steps of the procedure. They can pass through the filter pores when they are small enough and through unprotected areas when the filter is not completely apposed to the arterial wall. Therefore, they do not reliably prevent transient ischemic attacks and minor strokes, but major strokes. They are easier to handle than proximal balloon protection in normal anatomy and are safe in patients with moderate plaque burden and effective medication with platelet inhibitors and anticoagulation.