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

Ward, Thomas J.; Piechowiak, Rachel; Patel, Rahul; Fischman, A.; Nowakowski, F.; Kim, Edward; Ellozy, Sharif H.; Faries, Peter L.; Lookstein, R.

doi:10.1016/j.jvir.2014.07.016

Cited by 7 publications

(5 citation statements)

References 13 publications

(17 reference statements)

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“…Infrainguinal arterial thromboembolism in patients undergoing EVR is a well-known and feared complication with potentially devastating clinical sequelae. Although the use of the embolic protection device (EPD) during lower extremity EVR remains controversial because of its unclear effects on the prevention of thromboembolic events, high cost, potential damage to vessels and entrapment of the filter basket, it is widely accepted in cranial and carotid interventional procedures[ 15 – 17 ]. In a study by Mendes et al[ 16 ], embolic events occurred in 35 of 836 interventions (4%), including two (2%) performed with EPD and 33 (4%) performed without EPD (P > 0.05).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Aspiration Thrombectomy for Arterial Thromboembolism during Infrainguinal Endovascular Recanalization

et al. 2015

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ObjectivesTo evaluate the efficacy of percutaneous aspiration thrombectomy (PAT) for infrainguinal arterial thromboembolism in patients undergoing endovascular recanalization (EVR) and to investigate the predictors for thromboembolic complications.Materials and MethodsIn total, 23 patients (23 limbs) who underwent PAT for thromboembolism (PAT group, PG) during EVR and 237 patients (302 limbs) who underwent successful EVR without thromboembolic complications (control group, CG) were enrolled. Immediate post-operation and follow-up outcomes were compared between the two groups. Multivariate analysis was performed to identify the predictors of thromboembolic complications. Technical success of PAT was defined as achievement of <30% residual stenosis and restoration of mTIMI grade 3.ResultsThe technical success rate was 95.7% in PG. After intervention, the ankle–brachial index (ABI), restoration of blood flow and improvement in dorsal/plantar arterial pulse score showed no significant differences between PG and CG. During follow-up in PG, a sustained ABI improvement was observed in 63.6% (70.9% in CG), an improvement in walking distance in 68.8% (79.9% in CG,), ulcer healing in 75.0% (71.7% in CG) and restenosis/occlusion in 31.8% (25.2% in CG). The limb salvage rate was 100% in PG (96.0% in CG), and pain relief was observed in 66.7% patients with critical limb ischaemia (81.6% in CG). Superficial femoral artery involvement [0.233; 95% confidence interval (CI), 0.108–0.461; P < 0.001], de-novo lesion occlusion (683.8; 95% CI, 36.5–12804.6; P < 0.001) and intraluminal angioplasty (118.4; 95% CI, 8.0–1758.0; P = 0.001) was associated with high incidence of thromboembolism.ConclusionPAT is a safe and effective treatment for thromboembolism during infrainguinal arterial EVR. SFA involvement, de-novo lesion occlusion and intraluminal angioplasty may be predictors of thromboembolic complications.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Aspiration Thrombectomy for Arterial Thromboembolism during Infrainguinal Endovascular Recanalization

et al. 2015

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“…Although the use of the embolic protection device (EPD) during lower extremity EVR remains controversial because of its unclear effects on the prevention of thromboembolic events, high cost, potential damage to vessels and entrapment of the filter basket, it is widely accepted in cranial and carotid interventional procedures [15][16][17]. In a study by Mendes et al [16], embolic events occurred in 35 of 836 interventions (4%), including two (2%) performed with EPD and 33 (4%) performed without EPD (P > 0.05).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous aspiration thrombectomy for arterial thromboembolism during infrainguinal endovascular recanalization

Zhang

Cheng

2016

Journal of Vascular and Interventional Radiology

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“…24,27 While clinical efficacy remains debated, use of an EPD may be particularly applicable in CLI patients with single vessel runoff, or patients with acute thromboembolic occlusions. 28,29…”

Section: Treatment Considerationsmentioning

confidence: 99%

Long Chronic Total Occlusions: Revascularization Strategies

Sheeran

Wilkins

2018

Semin intervent Radiol

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The treatment of chronic total occlusions (CTO) in patients with peripheral arterial disease (PAD) is a complex topic with multiple treatment techniques and treatment strategies. The interventionalist treating patients with PAD should have both a defined treatment algorithm and multiple techniques available for crossing these challenging lesions. This article will cover techniques for treating CTOs and provide an overview of current available evidence.

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

Cited by 7 publications

References 13 publications

Percutaneous Aspiration Thrombectomy for Arterial Thromboembolism during Infrainguinal Endovascular Recanalization

Percutaneous Aspiration Thrombectomy for Arterial Thromboembolism during Infrainguinal Endovascular Recanalization

Percutaneous aspiration thrombectomy for arterial thromboembolism during infrainguinal endovascular recanalization

Long Chronic Total Occlusions: Revascularization Strategies

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