Abstract
A double cerebral protection system can resolve the intolerance to flow blockage, which is a problem with proximal protection devices. The goal of this study was to investigate the efficacy of a double cerebral protection system using distal filter and proximal embolic protection devices in carotid artery stenting (CAS). Diffusion-weighted MR imaging (MR-DWI) and major adverse events were used to evaluate this protective procedure. Between April 2008 and February 2010, CAS was performed for 69 sides. Twenty-one patients with high-risk lesions underwent CAS with double cerebral protection. New cerebral ischemic lesions were detected on MR-DWI in 14% (3/21) of the patients. There were no strokes, deaths, or myocardial infarctions within 30 days after the procedure. Three patients did not tolerate carotid artery flow reversal. However, a double cerebral protection system can easily be overcome to realize successful stenting. High-risk lesions can be safely treated with CAS using a double cerebral protection system.
