title: Carotid intervention 3: the evidence for cerebral protection.
abstract: Carotid stenting is a safe alternative option to conventional carotid endarterectomy in the treatment of carotid artery stenosis in patients considered poor candidates for surgery or who choose not to have open surgery. During the stenting procedure, however, distal embolization may occur with neurological sequelae. To reduce the incidence of this, several cerebral-protection devices (CPDs) have been developed. Different types of CPDs are now commercially available: distal occlusion balloons, distal filters, and proximal protection devices with or without reversal of flow. But complications can occur with their use and are usually associated with an inability to cross the lesion, failure to capture the emboli, vasospasm, and vessel wall injury. Because protection devices are currently the focus of interest by manufacturers and physicians, several trials are going on worldwide to analyze the characteristics of each of them and to evaluate their efficacy in reducing the rate of distal embolization.
authors.affiliation: Department of Radiological Sciences, Interventional Radiology Unit, University of Rome "La Sapienza," Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fanelli
authors.forename: Mario
authors.initials: M
authors.lastname: Bezzi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Boatta
authors.forename: Roberto
authors.initials: R
authors.lastname: Passariello