Approaches to difficult filter retrieval in carotid stenting.

The treatment of carotid disease continues to evolve with an increasing number of the lesions being successfully treated percutaneously. A large part of the success of percutaneous therapy has resulted from the use of distal protection devices and their ability to reduce embolization and subsequent strokes. However, device retrieval through implanted stents can be problematic. We describe situations in which difficulty was encountered advancing the distal protection filter retrieval device through the stent, as well as the different approaches to solve this potential problem.