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Carotid-artery angioplasty with stenting is a less invasive alternative to carotid endarterectomy (CEA). One problem with stenting, however, is that it causes embolization of plaque debris to the brain. To mitigate this problem, emboli-protection devices have been developed.
In this U.S. trial, supported by a maker of stents and protection devices, 334 patients underwent either CEA or protected carotid-artery stenting. The protection device used in stented patients (and invented by the lead author) was a filter basket that was placed distal to the carotid stenosis via a guidewire. After the procedure, the filter and its captured embolic material were removed. The trial included both asymptomatic patients with at least 80% stenosis and sympto…