الفهرس 
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Abstract
Background: The use of a distal filter cerebral protection device with carotid artery stenting (CAS) is commonplace. There is little evidence, however, that filters are effective in preventing embolic lesions. This study examined the incidence of embolic phenomenon during carotid artery stenting with and without filter use. Aim of the Work: was to compare procedural outcome among cases of CAS performed with the use of distal protection device to those performed without use of embolic protection device. Patients and Methods: A prospective randomized pilot study comparing carotid artery stenting with and without the use of embolic protection device in 40 patients who has either symptomatic carotid artery stenosis of at least 70% or an asymptomatic stenosis of at least 80% on DSCA (digital subteaction carotid angiography). Results: The mean age 66.1±8.94 in the protected group and 65.0±7.64 in the unprotected group, range 51–83 years). The patients’ demographic profile was 62.5% diabetes mellitus, 75% hypertension, 60% dyslipidemia and 37.5% smokers. 50.0% had evidence of coronary artery disease. There were no significant differences between both groups. Two stenosis (one of each group) were asymptomatic (5 %), and 38 were symptomatic (95 %). 72.5% had history of previous stroke and 30 % had transient ischemic attack (TIA), respectively. There were also no significant differences between both groups. Procedural success was 100% and there were no restenosis .The 3-month TIA / stroke / death rate was %: TIA 1 (2.5%) death 0 (0%), myocardial infarction 0 (0%) major stroke 0 (0%) and minor stroke 0 (0%). There was no neurological death. The Use of filter prolonged procedure duration by a mean of 10 minutes. Conclusion: There was no clinical significance in procedural and early post procedural outcomes of both groups and results were comparable or even less with most of CAS studies as most don’t include TIA. Our trial is too small to come to meaningful conclusions regarding clinical outcomes and should be considered as a pilot. Recommendations: Additional surrogate markers for clinical stroke that occur at a greater frequency would have considerable use to evaluate the efficacy of protection devices, cognitive studies, histologic analyses of the filter contents and subgroups analysis are needed.