AbstractIntracranial stenting, with or without balloon angioplasty, has emerged as an effective alternative to medical therapy for intracranial atherosclerosis. However, this strategy appears to involve the potential risk of distal embolization, which may lead to disability and death. Here, the authors have described a successful case of distal balloon‐protected intracranial carotid artery stenting for clinically and angiographically unstable intracarotid artery stenosis revealing aspirated embolic materials containing yellow plaque, red thrombus, and white debris. © 2008 Wiley‐Liss, Inc.