Clinical results of cerebral protection with a filter device during stent implantation of the carotid artery

Purpose: To assess the technical feasibility and the clinical results of ce rebral protection with the Angioguard embolicapture guidewire system during carotid artery stenting (CAS) for high-grade stenoses. Methods: In 20 patients 20 stenoses of the internal carotid artery were tre ated with stent implantation. In all patients diffusion-weighted (DW) magne tic resonance imaging (MRI) of the brain was performed before and 24 hr aft er the procedure. Results: The filter device was effectively employed during all steps of the procedure in 16 of 20 patients, in two only postdilation could be protecte d, and in two no protection was possible. After three of the 20 procedures new ipsilateral cerebral lesions were visualized by DW-MRI. No new permanen t neurologic deficits occurred. Conclusion: Cerebral protection with the filter device is technically feasi ble in most cases. DW-MRI demonstrated new cerebral lesions indicating the occurrence of cerebral microemboli during the protected procedures. Further investigations are necessary to determine whether the use of the cerebral protection device will improve the results of CAS.