Microembolization during the carotid artery stenting (CAS) procedure may cause cerebral lesions. Elevated C-Reactive Protein (hsCRP), Vascular endothelial growth factor (VEGF) and serum amyloid A protein (SAA) exert inflammatory activities thus promoting carotid plaque instability. Neuron specific enolase (NSE) is considered a marker of cerebral injury. However their clinical significance on the outcome of revascularization is unknown. This study aims to establish the correlation between embolization and serological markers. Serum hsCRP, SAA and VEGF pre-operatory levels were evaluated in patients with symptomatic carotid stenosis who underwent filter-protected CAS procedure. Patients with hsPCR<5mg/l, SAA<10mg/L and VEGF<500pg/ml were classified in class I or in class II for higher values. Plaques were characterized by grey scale median and classified as homogenous or dishomogenous. Cerebral embolization was evaluated by diffusion weight resonance magnetic imaging (DWI-MR) and through microscopical and ultrastructural analysis of filters, based on percentage of surface involvement (SI) and occluded pore (OP) by embolic material. Results were compared by Fisher's, Student T test and Mann-Whitney U test. Mean hsCRP, SAA and VEGF in 26 patients was respectively 13.43 mg/l, 42.24 mg/l e 509.85 pg/ml. In class I patients, with hsCR P < 5 mg/l, SAA<10mg/L and VEGF<500pg/ml, mean OP was 21.5% versus 35.3% for patients in class II (P < 0.05). In either group, embolic material captured by the filter was identified as atherosclerotic plaque fragments and platelets aggregates. Volume and number of cerebral lesions increased significantly in all patients with hsCRP > 5mg/l and SAA>10mg/l (16.5 vs 2.8 mean number, 3564.6 vs 417.6 mm3 mean volume). All patients presented an increase of 32% of NSE mRNA level expression after the CAS procedure. Finally, patients with indication to CAS had serological values of hsCRP, SAA and NSE three times greater compared to a group of patients submitted to carotid endarterectomy procedure. High hsCRP, SAA and VEGF levels in symptomatic patients are associated with significantly greater embolization during CAS. Cerebral lesions occurred in the group of patients with higher level of inflammation marker and OP. This preliminary data suggest that CAS might not be indicated as a method of revascularization in this specific group of patients.