Introduction The endovascular treatment of patients with acute ischemic stroke secondary to atheromatous occlusion of the extracranial internal carotid artery poses a challenge for the operator in cases where there is no intracranial occlusion or it affects a small vessel. This is because there is an increased risk of distal thromboembolic complications during angioplasty of the unstable plaque that has occluded.

Aim of Study The aim of this study is to demonstrate the efficacy and safety of a new technique used during the endovascular treatment of these patients.

Methods Retrospective analysis of the outcomes in patients treated with the technique, which involves using a stentretriever positioned in the M1-M2 segments as a distal carotid filter. The pusher wire of the retriever itself serves as a guide for angioplasty balloons.

Results This study included 18 patients with acute atherosclerosis-related CAO who were treated using the new endovascular approach. It prevents distal embolisms and reduces procedural time compared to conventional methods, as demonstrated by improved intervention times, higher first-pass efficiency, and reduced rates of distal embolism.

Conclusion This study demonstrates that using a stent retriever as a filter (in conjunction with BGCs) for treating acute atherosclerosis-related carotid artery occlusion is a safer and faster technique with a greater first-pass effect, and prevents distal embolisms compared to conventional techniques.