title: Effectiveness of the Combined Use of Distal Filter Protection Device and Mo.Ma Ultra: Technical Note.
abstract: BACKGROUND
  Although Mo.Ma Ultra is an embolic protection device for interrupting the anterograde blood flow to the internal carotid artery, incomplete blood stagnation is often observed. We report the effectiveness of the combined use of a distal filter protection device and Mo.Ma Ultra (Medtronic, Minneapolis, MN).
  
  
  METHODS
  Our case series comprises 10 consecutive patients (11 carotid arteries) who underwent carotid artery stenting (CAS) using Mo.Ma Ultra and FilterWire EZ (Boston Scientific, Natick, MA).
  
  
  RESULTS
  The superior thyroid artery originated from the proximal side of the bifurcation of the common carotid artery, except for 1 artery. Although complete blood stagnation was observed in 6 arteries, filter debris was detected in 3 of these 6 arteries. Positive postoperative findings on diffusion-weighted magnetic resonance imaging were observed in 3 cases (3 arteries). Only 1 patient had transient neurological deficits.
  
  
  CONCLUSIONS
  The combined use of a distal filter protection device and Mo.Ma Ultra could provide a more reliable embolic protection in CAS.
authors.affiliation: Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan. Electronic address: yomoteki@luke.ac.jp.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Moteki
authors.affiliation: Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Niimi
authors.affiliation: Department of Neurosurgery, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Sato
authors.affiliation: Department of Neurosurgery, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Neurosurgery, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Shima
authors.affiliation: Department of Neurosurgery, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Okada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D038524:Diffusion Magnetic Resonance Imaging; D057505:Embolic Protection Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012039:Regional Blood Flow; D015607:Stents; D016896:Treatment Outcome
keywords: Carotid artery stenting; FilterWire EZ; Mo.Ma Ultra; double protection