Recently carotid artery stenting (CAS) was upgraded in the class of recommendation among other revascularization treatments for symptomatic patients with carotid artery disease. This makes CAS potentially available to a broader range of patients. Significant evolution in CAS materials and protection devices contributed towards this improvement. Particularly in the setting of symptomatic carotid stenosis the most important cerebral protection devices available today, are the proximal protection systems. Comparing to the distal, filter-type protection devices, proximal protection systems can offer complete cerebral protection by preventing embolization of debris in the brain even before lesion crossing. In the present manuscript, we are reviewing all data regarding the efficacy of the flow-blockage proximal protection system (Mo.Ma®, Medtronic, Minneapolis, MN, US) as well as its potential advantages and drawbacks.
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