Distal Embolism During Percutaneous Revascularization of Infra-Aortic Arterial Occlusive Disease:An Underestimated Phenomenon

Abstract

The embolism phenomenon during infra-aortic interventions is frequent and underestimated. The liberated particles consisted primarily of atheromatous plaque elements and thrombus. The reported data might support the application of a protective filter basket in selected subsets of lesions with a riskier embolic profile and whenever declotting procedures are performed.

Revascularization for Critical Limb Ischemia Using the SpiderFX Embolic Protection Device in the Below-the-Knee Circulation: Initial Results

“…These results are in line with other lower-extremity case series in which the debris retrieval rates were between 12% and 89% (4,5,10,13). In our experience, lesion characteristics, lesion location, and treatment method were not significantly different between patients in whom debris was and was not retrieved.…”

“…Distal embolization is also a well documented phenomenon in the setting of infrainguinal percutaneous balloon angioplasty, stent placement, thrombolysis, and endovascular atherectomy (3)(4)(5)(6). However, the occurrence of this event has been viewed as largely insignificant (7).…”

An Overview of Optimal Endovascular Strategy in Treating the Femoropopliteal Artery: Mechanical, Biological, and Procedural Factors

“…Micro-and macrodebris are frequently captured with various embolic protection devices. [62][63][64][65][66] DE requiring further treatment occurs in 2 to 3% of unselected infrainguinal interventions. 67 Its predictors are long occlusions, thrombotic lesions, 67 mechanical thrombectomy, 26 directional atherectomy, 6,65 and laser atherectomy.…”

Percutaneous aspiration thrombectomy for arterial thromboembolism during infrainguinal endovascular recanalization

“…In addition, occlusion of the denovo lesion was a predictor of arterial thromboembolism during EVR. Karnabatidis et al [1] reported that CTO was positively correlated with a larger amount of captured particles (P < 0.05). In addition, histopathological examination of coronary artery CTO [14] showed that the intimal plaque in short-duration CTO was highly fibrotic with calcified lesions, while that in long-duration CTO was harder with more dense calcification.…”

“…The reported incidence is up to 98% [1]; however, the reported incidence of thromboembolic events that can be detected on angiography and cause clinical symptoms ranges from 1.6% to 24% [1,2]. Although surgical embolectomy is the classic and standard treatment for the management of thromboembolic complications in the lower extremity, endovascular techniques, including catheter-directed thrombolysis (CDT), percutaneous aspiration thrombectomy (PAT) and mechanical thrombectomy using dedicated peripheral arterial percutaneous thrombectomy devices, are increasingly being used for the removal of arterial emboli and restoration of blood flow [3][4][5].…”