Early experience in the application of distal protection devices in treatment of peripheral vascular disease of the lower extremities

Abstract

The objectives of this study were to reduce the risk of showering distal vessels with thromboemboli created during percutaneous interventions of the arteries in the lower extremities. Distal protection devices have been used in coronary and carotid interventions. Hence, using similar techniques, these filters and occlusion balloons were advanced past the targeted lesions and distally into femoral and popliteal arteries. Once opened, these devices allowed standard angioplasty and stent placement and captured the dislodged thromboemboli. Five cases were performed with the distal protection devices. One case used the distal occlusion balloon and four with the filter system. All five passed the lesion and were deployed. All five devices were retrieved without incident and were retrieved with substantial debris. There were no adverse events. The use of distal protection to treat high-risk or unstable lesions in the lower extremities shows great promise. Further case will be needed to evaluate the device for feasibility and safety.

Distal embolic protection during femoropopliteal atherectomy

“…We have had previous success with the use of distal protection in a small series of peripheral interventions in patients with poor distal runoff and with high risk of embolic debris [5]. Our initial use of the SilverHawk atherectomy catheter in tibial vessels in two patients resulted in occlusions that did not respond to angioplasty.…”

The Results of a New Distal Protection Method in Intervention for Chronic Total Occlusion of the Superficial Femoral Artery

“…If there is a risk of distal embolization, we believe it is best to use a method of embolic protection. It has been reported that distal protection devices, such as a guidewire with a balloon/filter and a balloon protection sheath, were beneficial in treating high-risk lesions of peripheral vascular disease [15, 16]. Another report on distal protection during femoro-popliteal atherectomy states that the filter wires retrieved debris after atherectomy in all cases and prevented distal embolic occlusion [17].…”

Plaque Excision in Management of Lower Extremity Peripheral Arterial Disease with the SilverHawk Atherectomy Catheter

“…This has been reported by others as well. 31 We have found Rinspiration (FoxHollow Technologies, Redwood City, CA) thrombectomy useful in instances of distal runoff vessel embolization.…”