title: Triple balloon protection technique using the mo.ma ultra with the carotid GuardWire for carotid stenting: technical note.
abstract: BACKGROUND
  We describe the "triple balloon protection technique" (TBPT) using the Mo.Ma Ultra in combination with the Carotid GuardWire during carotid artery stenting (CAS). This technique is expected to prevent distal embolism to the internal and external carotid arteries, and is suitable for East Asians in whom the origin of the superior thyroid artery is lower than that in Caucasians.
  
  
  METHODS
  From December 2012 to May 2013, 11 patients underwent CAS using TBPT in our center.
  
  
  RESULTS
  Procedural success was achieved in all patients. Complete flow blockade by angiography could not be obtained in 8 patients (72.7%) by proximal occlusion using the Mo.Ma Ultra only. Complete angiographic flow blockade was obtained in all patients by TBPT. No major adverse cardiovascular events, including stroke, myocardial infarction, or death because of any cause, occurred within 30 days.
  
  
  CONCLUSIONS
  The use of TBPT for CAS may be effective for preventing distal embolisms, especially for East Asians.
authors.affiliation: Comprehensive Stroke Center, Kobe City Medical Center General Hospital, Kobe, Japan; Division of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation, Kobe, Japan. Electronic address: asai-osk@umin.ac.jp.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Asai
authors.affiliation: Comprehensive Stroke Center, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Imamura
authors.affiliation: Comprehensive Stroke Center, Kobe City Medical Center General Hospital, Kobe, Japan; Division of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation, Kobe, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Mineharu
authors.affiliation: Comprehensive Stroke Center, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Tani
authors.affiliation: Comprehensive Stroke Center, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Hidemitsu
authors.initials: H
authors.lastname: Adachi
authors.affiliation: Comprehensive Stroke Center, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Narumi
authors.affiliation: Comprehensive Stroke Center, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Todo
authors.affiliation: Comprehensive Stroke Center, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Hoshi
authors.affiliation: Comprehensive Stroke Center, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Sato
authors.affiliation: Comprehensive Stroke Center, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kono
authors.affiliation: Division of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation, Kobe, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Sakai
authors.affiliation: Comprehensive Stroke Center, Kobe City Medical Center General Hospital, Kobe, Japan; Division of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation, Kobe, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sakai
mesh_terms: D044466:Asian People; D021721:Balloon Occlusion / Q000295:instrumentation* / Q000379:methods; D016893:Carotid Stenosis / Q000601:surgery / Q000628:therapy*; D002533:Cerebral Angiography; D003326:Coronary Circulation; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D015607:Stents; D016896:Treatment Outcome
keywords: Carotid artery stenting; GuardWire; Mo.Ma; protection device; triple balloon