EmPro™ Embolic Protection System: Distal Filter Protection During Carotid Artery Stenting

The EmPro™ is a distal embolic protection device (EPD) from MicroVention Terumo consisting of a self-expanding nitinol filter basket mounted on a 190 cm guidewire. It is deployed distal to the carotid stenosis before intervention begins; the filter captures atherosclerotic debris and thrombus fragments liberated during stent delivery and post-dilation; and is retrieved after intervention to remove the captured material.

Embolic protection during carotid artery stenting is guideline-supported by both AHA and ESC, driven by robust data showing that particulate embolization during stent delivery is a primary mechanism of peri-procedural stroke. EmPro provides a physical barrier that intercepts debris before it reaches the intracranial circulation.

EP4514C-190 (small, 3.0–4.5 mm vessels, 190 cm) and EP6514C-190 (large, 4.5–6.5 mm, 190 cm). The 190 cm working length covers femoral access in virtually all adults. Sizing is based on the reference vessel diameter distal to the target lesion, where the filter basket will be deployed. The self-expanding nitinol frame opens the filter against the vessel wall upon sheath retraction without operator balloon inflation.

After the CAS procedure, a retrieval catheter is advanced over the EmPro wire to collapse and capture the filter basket, withdrawing the captured debris as a contained unit.

The combination of EmPro distal filter protection and CASPER dual-layer micromesh stenting represents a two-mechanism embolic protection strategy: the CASPER inner micromesh prevents plaque prolapse through stent struts (the primary intra-procedure embolic mechanism) while the EmPro captures any debris released during the procedure before it reaches the intracranial circulation.

Both EmPro and CASPER are part of the MicroVention Terumo carotid stenting portfolio, allowing the complete CAS setup to be sourced from a single regional partner via Modern Medical Solutions. This is operationally advantageous for programs ordering combined procedure kits.

Deploy the EmPro filter 3–4 cm beyond the carotid bifurcation in a straight segment free of significant stenosis, confirming full filter opening under fluoroscopy before proceeding. An incompletely opened filter will not provide effective protection.

After CASPER deployment and post-dilation, advance the retrieval catheter over the wire to the filter level, engage the basket, and withdraw as a contained assembly. Inspect the retrieved filter for captured debris. DAPT loading should be completed before the procedure per standard carotid stenting protocol.

Modern Medical Solutions is the authorised MicroVention Terumo distributor for Tajikistan and Afghanistan. EmPro is available in both EP4514C-190 and EP6514C-190 for carotid stenting programmes in Tajikistan and Afghanistan.

Contact Modern Medical Solutions to order EmPro alongside CASPER carotid stent as a complete carotid artery stenting system with dual embolic protection.