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Background and Purpose Carotid artery stenting (CAS) for acute ischaemic stroke with tandem lesions carries a recognised risk of thromboembolic complications and haemorrhage, particularly in the absence of dedicated embolic protection. The CaRotid Artery Filtering Technique (CRAFT) utilises staged deployment of a dual-layer micromesh CASPER RX stent to provide intrinsic distal embolic protection during revascularisation. This study evaluates the safety and clinical outcomes of CRAFT-assisted CAS across emergent and non-emergent settings in a large multicentre Australian cohort, with particular focus on major adverse event rates.Materials and Methods A retrospective review was performed of all patients undergoing CAS using the CASPER RX stent with CRAFT at three tertiary neurointerventional centres. Demographic, procedural and follow-up data were extracted from institutional electronic records. Primary safety outcomes included a composite of major adverse events (death, stroke or symptomatic intracranial haemorrhage). Procedural success and functional outcomes were also assessed.Results A total of 215 patients (mean age 70 years; 74% male) underwent CRAFT-assisted CAS. Most procedures were performed emergently (89%), with tandem intracranial occlusion present in 72% of cases. Median admission NIHSS improved from 12 to 6 following intervention, and successful reperfusion (mTICI ≥ 2b) was achieved in 98% of patients. Symptomatic intracranial haemorrhage occurred in 10% of cases and stent thrombosis or occlusion in 7%. Overall mortality during follow-up was 8%, while 4% of patients required permanent residential care following discharge. Moderate-to-severe in-stent restenosis was observed in 8% on follow-up imaging. The composite absence of major adverse events was 86% in the overall cohort, increasing to 96% when non-emergent cases were analysed separately. Notably, all instances of stent occlusion occurred in the emergent treatment group. Median modified Rankin Scale score at first outpatient follow-up was 1, suggesting favourable early functional recovery in most patients.Conclusions CRAFT-assisted deployment of the CASPER RX stent demonstrates a favourable safety profile in both emergent and elective CAS, with high technical success and low rates of major adverse events. While complications were predominantly confined to the emergent stroke cohort, non-emergent cases demonstrated excellent short-term safety outcomes. These findings support the continued evaluation of intrinsic embolic protection strategies in carotid revascularisation, particularly in high-risk acute stroke populations.Disclosures Y. Wardak: None. A. Dahan: None. S. Kulkarni: None. C. Gan: None. D. Pavlin-Premrl: None. K. Zhou: None. Y. Ren: None. V. Vainauskaite: None. S. Protto: None. J. Moore: None. R. Chandra: None. W. Chong: None. L. Slater: None. M. Nasra: None. A. Khabaza: None. J. Maingard: None. A. Jhamb: None. H. Kok: None. M. Brooks: None. C. Barras: None. H. Asadi: None.Abstract P-008 Figure 1