ABSTRACT
Distal embolization of arteriosclerotic debris and thrombus is the most common and often the most severe complication of carotid angioplasty and stenting. The first distal embolic protection device was developed in the 1990s by Theron et al. This was a triple coaxial catheter with a small latex balloon at the tip of a microcatheter. With this latex balloon the internal carotid artery was occluded distal to the lesion. The dilation catheter could be advanced over the microcatheter. After the angioplasty the debris was aspirated via the guiding catheter. For several reasons no randomized trials examining angioplasty and stenting without embolic protection devices versus with embolic protection devices have been done. The majority of the ongoing trials designed to compare stenting and surgery include the use of an embolic protection device. All devices placed distally in the internal carotid artery may cause spasm or dissection.
