Recent reports in the literature show that carotid angioplasty and stenting is an acceptable alternative to carotid endarterectomy in the treatment of carotid artery stenosis in a specific population. The procedure, however, has some possible complications, and distal embolization can occur and may cause stroke or even death [1]. In the past decade, several different techniques and devices have been developed to prevent cerebral damage associated with accidental embolization. The principal types of cerebral protection devices (CPD) are proximal and distal occlusion balloons, distal filters, and reversal-of-flow mechanisms [2]. Transcranial Doppler studies carried out during carotid artery stenting (CAS) procedures have shown that high-intensity transient signals consistent with microem-bolization occur during simple manipulation of the guidewire across the lesion [3] and throughout the procedure unless flow reversal is applied.