Lesion types and device characteristics that predict distal embolization during percutaneous lower extremity interventions

Abstract

DE is a rare event that occurs more often with the Jetstream and DiamondBack 360 devices. In-stent and complex native lesions are at higher risk for DE. DE is typically reversible with endovascular techniques and has no effect on patency rates and limb salvage.

Critical limb ischemia: an update for interventional radiologists

“…However, with the advent of newer and less invasive tools, the safety and efficiency of each procedure should also be considered in determining the best treatment strategy. One study examined the safety standard of all percutaneous lower extremity techniques, including atherectomy devices, primary PTA and PTA with stent placement, by evaluating the likelihood of a given procedure producing a distal embolic event (58). In this study, the Jetstream Atherectomy Catheter and the Diamondback 360 catheter were associated with significantly greater embolization rates than other tested treatment modalities (58).…”

“…One study examined the safety standard of all percutaneous lower extremity techniques, including atherectomy devices, primary PTA and PTA with stent placement, by evaluating the likelihood of a given procedure producing a distal embolic event (58). In this study, the Jetstream Atherectomy Catheter and the Diamondback 360 catheter were associated with significantly greater embolization rates than other tested treatment modalities (58). Embolic protection devices, primarily used with carotid artery stenting, are available, and some can be used with both the Jetstream and Silverhawk atherectomy catheters.…”

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

“…The reported incidence of DE, detected angiographically or clinically, ranges from 1% to 5% [2]. DE may necessitate additional intervention, including thrombectomy or thrombolysis, resulting in longer procedure time, more contrast used, and greater radiation exposure [3].…”

“…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].…”

CT angiography and magnetic resonance angiography findings after surgical and interventional radiology treatment of peripheral arterial obstructive disease

“…A higher rate of distal embolization is associated with in-stent restenosis and chronic total occlusions in TASC II C and D lesions as compared with TASC A and B lesions. 34 Late complications include pseudoaneurysms and stent occlusion or restenosis due to recurrent obliterative disease.…”