During carotid artery stenting for a high-grade symptomatic internal carotid artery stenosis, what is the purpose of a distal protection device deployed across the lesion before angioplasty?

• A To dilate the stenosis mechanically before stenting
• B To measure the residual pressure gradient across the stenosis
• C To deliver heparin directly into the plaque
• D To trap embolic debris dislodged during predilation and stenting, preventing cerebral embolization ✓

Explanation

The dominant risk during carotid stenting is distal embolization of plaque fragments during predilation, stent deployment, and post-dilation. Distal filters or occlusion balloons placed beyond the lesion capture this debris, which is retrieved before device removal, reducing procedural stroke rates. Dilation is performed by balloons, not the protection device itself, and cerebral protection is achieved mechanically rather than pharmacologically.

Reference: Grainger and Allison's Diagnostic Radiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.