Use of Embolic Protection Devices in Peripheral Interventions

Abstract

The use of embolic protection devices (EPDs) when treating coronary saphenous vein bypass grafts, performing carotid arterial stenting and treating acute coronary syndromes is well accepted. We will review currently available devices and approaches to reduce distal embolisation, first discussing their uses in carotid interventions and then in vertebral and peripheral vascular interventions.

Use of Wallstent device as an embolic protection device during stenting of aortic thrombus

“…Distal embolization is a concern during instrumentation and aortic stenting, 6 especially in our patient with an initial presentation of blue toe syndrome, suggesting the presence of an unstable thrombus or plaque. Given that the aortic thrombus was flow occluding, wire passage would have a high risk of dislodging part of the thrombus.…”

“… 5 Distal embolization remains a concern during instrumentation. 6 We describe the use of a reconstrainable Wallstent endoprosthesis (Boston Scientific) as an embolic protection device during stenting of an aortic mural thrombus in a patient who presented with blue toe syndrome. The institutional ethics board waived the requirement for institutional review board approval.…”

Comparison and Analysis between the NAV6 Embolic Protection Filter and SpiderFX EPD Filter in Superficial Femoral Artery Lesions

“…While the safety and efficacy of Spider FX has been well established and leads to indication in the use of atherectomy for calcified femoropopliteal disease, Emboshield offers several advantages. These include the use of BareWire® technology that allows the Emboshield wire and filter to move independently of each other, providing flexibility in how clinicians use the filter to track during procedures [ 20 ]. Spider FX EPDs do not have this feature of moving independently of the delivery guidewire.…”

Coronary‐subclavian steal syndrome, an easily overlooked entity in interventional cardiology

“…Recently, embolic protection devices (EPD) were introduced in order to minimize stroke risk during vascular procedures. The clear potential benefit of these devices needs to be balanced with increased procedure time and complexity as well as their complication risk (mainly vessel dissection and ischemia) . Therefore, EPD are not routinely used in our center during PTA and stenting of SAS.…”