Cerebral protection devices for carotid stenting

Embolization during every phase of the procedure of CAS was the principle obstacle in the diffusion of this methodology. The introduction of the cerebral protection system has permitted results which are comparable with those of surgery. A large variety of protection systems have been proposed, of which the most used are those with filters and proximal occlusion systems with double balloons. Each of these devices have advantages and disadvantages depending upon the anatomical conditions in which they are applied and no one study has demonstrated greater effectiveness of one device over another in statistical terms even if, in difficult anatomical conditions, the devices with a double balloon system seem to perform better . In spite of the use of cerebral protection devices, embolic complications during CAS continues to occur. The use of cerebral protection devices should be evaluated according, not only to the methods of a total protection based on the characteristics of the patient to treat, but also on the selection of the lesions, the imaging equipment and the level of expertise and unity of the whole team.