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Clinical significance of embolic events in patients undergoing endovascular femoropopliteal interventions with or without embolic protection devices 

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Presentation on theme: "Clinical significance of embolic events in patients undergoing endovascular femoropopliteal interventions with or without embolic protection devices "— Presentation transcript:

1 Clinical significance of embolic events in patients undergoing endovascular femoropopliteal interventions with or without embolic protection devices  Bernardo C. Mendes, MD, Gustavo S. Oderich, MD, Mark D. Fleming, MD, Sanjay Misra, MD, Audra A. Duncan, MD, Manju Kalra, MBBS, Stephen Cha, MS, Peter Gloviczki, MD  Journal of Vascular Surgery  Volume 59, Issue 2, Pages e1 (February 2014) DOI: /j.jvs Copyright © 2014 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Double-wire technique of superficial femoral artery intervention with embolic protection. Once true lumen access is confirmed with passage of a inch catheter, a inch Spider RX embolic protection device (EPD) (Covidien, Plymouth, Minn) is loaded inside the inch catheter, advanced, and deployed at or below the level of the knee joint. A inch V18 guidewire (Boston Scientific, Natick Mass) is used as a “buddy wire” to provide support for interventions done using inch system, and to facilitate retrieval of the filter basket while avoiding entrapment of the retrieval catheter in the struts of the stent (A). Balloon angioplasty is performed with the EPD in place (B), followed by deployment of a self-expanding stent (C). Moderate to severe macroscopic debris was captured in 45% of filter baskets (D). Panels A-C are reproduced by permission of the Mayo Foundation for Medical Education and Research. All rights reserved. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Example of a case of distal embolization successfully treated with thrombolysis and catheter aspiration. Left lower extremity selective angiography demonstrates a segmental occlusion of the superficial femoral artery (SFA; A) and patent tibioperoneal trunk (B). After crossing of the SFA lesion, the angiogram reveals occlusion at the bifurcation of the tibioperoneal trunk, with compromise of flow to both arteries (C; arrowhead). After catheter aspiration of thrombus followed by continuous catheter-directed thrombolysis during 8 hours, completion angiography demonstrates improved flow and patent tibioperoneal trunk (D). Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Kaplan-Meier estimates of primary patency (A) and freedom from reintervention (B) in patients treated for chronic limb ischemia by percutaneous interventions with embolic protection device (EPD) or without EPD (No EPD). Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

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