The aims of this study were to analyze the results of carotid artery stenting using distal protection with FilterWire, and evaluate the effectiveness of FilterWire for distal embolic protection.

Between June and December in 2004, elective carotid artery stenting using FilterWire was attempted in 25 lesions of 24 consecutive patients. All patients were symptomatic, with recurrent transient ischemic attacks (TIA) or a stroke. The cerebral ischemic lesions of embolic origin were evaluated before and after the procedure using magnetic resonance imaging, including diffusion-weighted images. Both pre- and post-procedural 99mcTc-ECD SPECT were performed to assess the cerebral blood flows. Any visible debris within the FilterWire was sent for histological/cytological analyses.

Technical success was achieved all 25 cases. The mean pre-procedural stenosis was 89% (range 70-100%), and that immediately after stent placement was nearly 0%. With the exception of only one major stroke (1/25, 4%), no periprocedural complications were encountered. On the diffusion weighted images, new lesions were observed in four patients (4/25, 16%), but these were clinically silent. FilterWire-related transient spasm occurred in eight of the 25 procedures (32%).

Carotid artery stenting, with FireWire distal protection, seems technically feasible, safe and effective in preventing procedural related embolic complications.