Dual cerebral protection technique during carotid stenting.
OBJECTIVE
To present a technique for internal carotid artery stenting (CAS) with dual cerebral protection in patients with high-grade stenosis caused by large, soft atherosclerotic plaques.


METHODS
The MO.MA proximal cerebral protection device is first placed in the external and common carotid arteries. Complete blockade of blood flow is achieved by inflating the occlusion balloons. A Spider filter is delivered to the distal internal carotid artery. All procedural steps of CAS are performed during continuous and simultaneous proximal occlusion and distal filter protection. After postdilation of the stent, the occlusion balloons are deflated, and antegrade flow is re-established with the distal filter basket still open.


CONCLUSIONS
In selected patients with large atherosclerotic plaques, a dual cerebral protection technique during CAS may be a more efficacious form of cerebral protection than a single protection device.
Milosevic
Zoran V
ZV
Department for Neuroradiology, Clinical Radiology Institute, University Clinical Centre Ljubljana, Slovenia. zoran.milosevic@guest.arnes.si
Kocijancic
Igor J
IJ
Bunc
Matjaz
M
Bajrović
Fajko F
FF
Zvan
Bojana
B
D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects*; D021721:Balloon Occlusion / Q000295:instrumentation* / Q000379:methods; D002340:Carotid Artery Diseases / Q000150:complications; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology; D002342:Carotid Artery, External / Q000000981:diagnostic imaging / Q000503:physiopathology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000503:physiopathology; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000517:prevention & control*; D004867:Equipment Design; D005374:Filtration / Q000295:instrumentation; D006801:Humans; D020766:Intracranial Embolism / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012039:Regional Blood Flow; D012720:Severity of Illness Index; D015607:Stents; D018616:Ultrasonography, Doppler, Duplex