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 cerebral 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 treated with stent implantation. In all patients diffusion-weighted (DW) magnetic resonance imaging (MRI) of the brain was performed before and 24 hr after 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 protected, and in two no protection was possible. After three of the 20 procedures new ipsilateral cerebral lesions were visualized by DW-MRI. No new permanent neurologic deficits occurred. Conclusion: Cerebral protection with the filter device is technically feasible 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.