Cerebral embolic protection devices are specialized intravascular devices designed to reduce the risk of cerebral embolization during cardiovascular procedures that carry a risk of dislodging embolic debris, such as transcatheter aortic valve replacement (TAVR) and carotid artery stenting (CAS).
These devices function by either capturing or deflecting embolic materials-thrombus, atheromatous debris, calcific fragments, that may be released during manipulation of the aorta or great vessels, thereby preventing this material from reaching the cerebral circulation and causing ischemic stroke or silent cerebral infarcts.
Several types of cerebral embolic protection devices exist: including distal filter devices, distal occlusion devices, and proximal occlusion or flow reversal systems.
Distal filter devices are most commonly used in carotid artery stenting and are deployed distal to the lesion to trap debris while maintaining antegrade flow.
In TAVR, the Sentinel device uses dual filters placed in the brachiocephalic and left common carotid arteries to capture debris during valve deployment.
These devices in their guidelines for carotid and aortic interventions, noting that cerebral embolic protection can reduce the risk of periprocedural stroke, although the magnitude of clinical benefit—particularly in TAVR—remains an area of ongoing investigation.