Aims. To determine the efficacy of a new distal protection method in SFA CTO interventions.
Methods and Results. From June
2003 to February 2009, ninety-two consecutive,
chronic total occlusions of superficial femoral
arteries were treated with catheter-based
intervention using a bidirectional approach.
Nine of these cases were managed with our
original, distal protection method, based on
symptoms, angiographic images, wire resistance,
and intravascular ultrasound images. The average
age was 73 years; eight patients were male. The
mean occlusion length was 17.1 cm. A
distal protection balloon was inserted from the
retrograde sheath in the popliteal artery and
placed distal to the occluded lesion after
successful wire crossing. Lesion dilatation with
a balloon was performed antegradely and debris
was removed by 6Fr. guiding catheter. Debris was
retrieved from all lesions, consisting mainly of
thrombus. Where we decided not to use the distal
protection method, there was no distal
thromboembolism. Conclusion. In
SFA-CTO intervention, the risk of distal
embolization is 10%, which can be
anticipated and eliminated by the distal
protection method.