Role of distal protection during carotid stenting.

The most common complication of carotid angioplasty is distal embolization of debris and/or thrombus. The only way to avoid this complication is with the use of embolic protection devices. Several filters, distal balloon occlusion devices, and proximal balloon occlusion devices are available. These devices make it possible to capture arteriosclerotic debris during angioplasty and stenting. During the majority of procedures at least some particles can be retrieved. Therefore there is no doubt that these devices are important for carotid angioplasty. However, due to the low complication rate of carotid angioplasty even without embolic protection devices, large randomized trials are necessary to statistically prove the clinical efficacy of these devices.