Role of filter design in embolic protection during carotid artery stenting

Endovascular carotid intervention has undergone a dramatic and rapid evolution since its early inception in the 1990s at which time it comprised a rudimentary angioplasty technique. Quite apart from changes in the size and format of the guidewires used (0.014 inch, rapid-exchange compatible) and stents and balloons (dedicated, low-profile), perhaps one of the most interesting developments has been the introduction of cerebral protection devices. These devices are intended to control the emboli generated by carotid artery stenting and thereby reduce the embolic complications of the procedure. A number of different cerebral protection systems are available but this article will focus on the most popular: the filter.