Initial Experience With the 5×300-mm Proteus Embolic Capture Angioplasty Balloon in the Treatment of Peripheral Vascular Disease

Abstract

In this small series, the 5 × 300-mm ECA embolic capture balloon catheter was an effective tool for avoiding embolic events in long peripheral lesions, with a good safety profile. The device might be considered as part of routine clinical practice for complex TASC II C/D femoropopliteal lesions.

Periprocedural Myocardial Infarction After Carotid Endarterectomy and Stenting

“…16 As expected, in our study, the main risk factor for periprocedural MI was a history of coronary artery disease. The risk of periprocedural MI has never been compared in lower extremity artery between surgery and angioplasty/stenting; only few studies [30][31][32] reported this risk after surgery and only 1 33 after angioplasty/stenting. Thus, uncertainty remains on whether our results are specific or not of the carotid artery.…”

Reply:

“…If we assumed that EPDs could benefit some subgroups (otherwise EPDs would be useless in lower extremity interventions), then it is theoretically more likely to be beneficial in patients with higher distal embolization risk, such as the TASC II C/D subgroup. 3,5 Zeller and colleagues presented an excellent illustration of the 53300-mm Proteus ECA balloon in this interesting subgroup, with an embolic debris capture rate of 25% (5/20), much higher than the angiographically evident embolization rate, 5 but much lower than the embolic debris capture rate in some recent studies. 3,4 The average number of particles .2 mm in diameter was 7.67, and all samples contained 1 to 3 particles .4 mm in diameter.…”

“…3,5 Zeller and colleagues presented an excellent illustration of the 53300-mm Proteus ECA balloon in this interesting subgroup, with an embolic debris capture rate of 25% (5/20), much higher than the angiographically evident embolization rate, 5 but much lower than the embolic debris capture rate in some recent studies. 3,4 The average number of particles .2 mm in diameter was 7.67, and all samples contained 1 to 3 particles .4 mm in diameter. These particles may cause severe ischemic consequences if not captured, and these high-risk patients may benefit from the ECA device, but we will never know that until a prospective randomized control study is conducted, which was also recommended by the authors.…”

Incidence, Risk Factors, Treatment and Prognosis of Popliteal Artery Embolization in the Superficial Femoral Artery Interventions

“…The concern for DE in lower extremity interventions has led to a debate [4]. Some recommend the use of a variety of embolic protection devices (EPDs) [5], [6], [7], while other evidence suggested that EPDs may be unnecessary [2], [8]. Clinical data have shown that the application of EPDs in lower extremity is generally safe [4].…”