The risk of embolization during carotid artery stenting (CAS) has been the foremost reason for the cautious acceptance of this percutaneous alternative to carotid endarterectomy. To address this issue, numerous embolic protection devices are being evaluated as an adjunct to CAS for neuroprotection. Among the 3 main categories of these devices, distal filters, which trap embolic debris while maintaining distal cerebral perfusion, have attracted the most corporate interest. This review focuses on the emerging field of embolic protection filters for use in CAS.
YadavSSRoubinGSIyerSS. Elective stenting of the extracranial carotid arteries. Circulation. 1997; 95: 376–381.
2.
RoubinGSNewGIyerSS. Immediate and late clinical outcomes of carotid artery stenting in patients with symptomatic and asymptomatic carotid artery stenosis. Circulation. 2001; 103: 532–537.
3.
WholeyMHWholeyMMathiasK. Global experience in cervical carotid artery stent placement. Catheter Cardiovasc Interv.2000; 50: 160–167.
4.
CriadoFJLingelbachJMLedesmaDF. Carotid artery stenting in a vascular surgery practice. J Vasc Surg.2002; 35: 430–434.
5.
RathPCAgarwalaMKVenkateswarluJ. Carotid angioplasty under cerebral protection with “PercuSurge Guardwire.”Indian Heart J.2000; 52: 461–463.
6.
HenryMAmorMHenryI. Carotid stenting with cerebral protection: First clinical experience using the PercuSurge GuardWire system. J Endovasc Surg.1999; 6: 321–331.
7.
SchluterMTublerTMatheyDG. Feasibility and efficacy of balloon-based neuroprotection during carotid artery stenting in a single-center setting. J Am Coll Cardiol.2002; 40: 890–895.
8.
ParodiJCLa MuraRFerreiraLM. Initial evaluation of carotid angioplasty and stenting with three different cerebral protection devices. J Vasc Surg.2000; 32: 1127–1136.
9.
JaegerHMathiasKDrescherR. Clinical results of cerebral protection with a filter device during stent implantation of the carotid artery. Cardiovasc Intervent Radiol.2001; 24: 249–256.
10.
ReimersBCorvajaNMoshiriS. Cerebral protection with filter devices during carotid artery stenting. Circulation. 2001; 104: 12–15.
11.
BosiersMPeetersPVerbistJ. Belgian experience with FilterWire EX in the prevention of embolic events during carotid stenting. J Endovasc Ther.2003; 10: 695–701.
12.
CastriotaFCremonesiAManettiR. Impact of cerebral protection devices on early outcome of carotid stenting. J Endovasc Ther.2002; 9: 786–792.
13.
CremonesiACastriotaF. Efficacy of a nitinol filter device in the prevention of embolic events during carotid interventions. J Endovasc Ther.2002; 9: 155–159.
14.
MacdonaldSMcKevittFVenablesGS. Neurological outcomes after carotid stenting protected with the NeuroShield Filter compared to unprotected stenting. J Endovasc Ther.2002; 9: 777–785.
15.
Müller-HülsbeckSJahnkeTLiessC. In vitro comparison of four cerebral protection filters for preventing human plaque embolization during carotid interventions. J Endovasc Ther.2002; 9: 793–802.
16.
Al-MubarakNColomboAGainesP. Multicenter evaluation of carotid artery stenting with a filter protection system. J Am Coll Cardiol.2002; 39: 841–846.
17.
OhkiTRoubinGSVeithFJ. Efficacy of a filter device in the prevention of embolic events during carotid angioplasty and stenting: An ex vivo analysis. J Vasc Surg.1999; 30: 1034–1044.
18.
YadavJ. Stenting and angioplasty with protection in patients at high risk for endarterectomy (the SAPPHIRE study). AHA Scientific Sessions, November 17–22, 2002; Chicago, Illinois, USA.