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Figure 2 Schematic of proposed mechanism of slow-flow and rationale for aspiration prior to retrieval of filter. (A) Carotid bifurcation lesion with filter placed in the distal internal carotid artery (ICA). (B and C) Balloon angioplasty and stenting results in distal embolization of debris from atherosclerotic plaque causing occlusion of filter pores and accumulation of debris in stagnant column of blood proximal to the filter. (D and E) Aspiration proximal to the filter removes the debris from the stagnant column of blood without affecting the debris causing occlusion of the filter. CCA = common carotid artery.
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