Double Filters: A Protection Technique for High-Risk Innominate Artery Angioplasty

In the carotid territory, certain atherosclerotic plaque features (i.e., soft, lipid-rich) have been associated with a high risk of microembolization during distal-protected angioplasty with stent implantation,4 which is one reason that many high-volume centers preferentially use proximal neuroprotection systems for carotid artery stenting.5,6 During IA angioplasty, the use of a protection system is more challenging as both the carotid and vertebral arteries may be the paths for antegrade debris migration.