Distal Versus Proximal Protection on Cerebral Microembolization During High-risk Carotid Artery Stenting

Who can take part

• Male and female patients 40 years of age and older
• Asymptomatic patients with internal carotid artery stenosis≥70% on angiography
• Symptomatic patients with internal carotid artery stenosis≥50% on angiography
• High-intensity Signal in the relevant plaques on the TOF-MRA
• Anatomic characteristics of the lesions that made it possible to use either type of embolism protective device (proximal or distal)
• The patient or legally authorized representative has been informed of the nature of the study, agrees to its provisions, and has provided written informed consent, approved by the appropriate Medical Ethics Committee, Institutional Review Board, or Human Research Ethics Committee

Who cannot take part

• Chronic or paroxysmal atrial fibrillation treated with oral anticoagulation
• Extensive ipsilateral or disabling stroke(mRS≥2)
• Ischemic ipsilateral stroke in 15 days, with significant new ischemic lesions on the DWI image
• Acute coronary syndrome in the 30-day period before the procedure
• Patient has a history of bleeding diathesis within 1 month or coagulopathy or patients in whom antiplatelet and/or anticoagulant therapy is contraindicated
• Intolerance or allergic reaction to a study medication without a suitable management alternative
• Ipsilateral intracranial artery stenosis which needs to be treated at the same time
• Extremely calcified aortic arc that compromised the origin of the common carotid artery or the brachiocephalic trunk
• Pregnant or lactating female patient