REVIEW  PROXIMAL PROTECTION IN CAROTID ARTERY STENTING: WHO’S AFRAID OF IT? Free access

Minerva Cardiology and Angiology 2022 December;70(6):738-50

DOI: 10.23736/S2724-5683.22.06222-6

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Absolute and relative contraindications to proximal protection: do they really matter? A case-illustrative approach

Piero MONTORSI ^{1, 2} ✉, Stefano GALLI ², Giovanni TERUZZI ², Luigi CAPUTI ³, Paolo RAVAGNANI ², Andrea ANNONI ², Sarah TROIANO ², Stefano DE MARTINI ², Federico DE MARCO ², Giulia SANTAGOSTINO BALDI ², Daniela TRABATTONI ²

¹ Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; ² Centro Cardiologico Monzino IRCCS, Milan, Italy; ³ Division of Neurology, ASST Crema, Crema, Cremona, Italy

Carotid artery stenting (CAS) is an established technique to treat carotid artery stenosis. Favorable results have been reported in different subsets of patients in both acute and long-term settings. Among the CAS periprocedural variables the type of cerebral protection - distal filter and proximal protection - play a pivot role to reduce cerebral embolization. Accumulating evidence is in favor of better performance of proximal protection vs. distal filters. However, the rate of worldwide penetration of this devise is low. Potential reasons include a lengthy list of technical issues that may account for the reluctance of filter-oriented operators to change systems. This paper shows how to identify, treat, and overcome these technical obstacles.

KEY WORDS: Carotid arteries; Stents; Complications