Cerebral Embolic Protection

Carotid angioplasty and stenting (CAS) is rapidly evolving into a viable alternative to carotid endarterectomy (CEA). This has been possible due to advances in endoluminal equipment and the development of mechanical cerebral embolic protection devices. Theoretically, these various devices reduce the occurrence of distal embolization into the intracranial circulation and thereby minimize the clinical consequence of a cerebrovascular accident. Embolic protection systems are currently classified into three main categories depending on the mechanism: 1) distal occlusion; 2) distal filtration; and 3) proximal occlusion. This review will provide a framework with regard to these devices with some specific examples cited.