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Erschienen in: CardioVascular and Interventional Radiology 8/2017

08.03.2017 | Clinical Investigation

Intraprocedural Distal Embolization After Femoropopliteal Angioplasty: Is There a Role for Below-the-Knee Stents?

verfasst von: Miltiadis Krokidis, Tariq Ali, Nicholas Hilliard, Nadeem Shaida, Andrew Winterbottom, Brendan Koo, Teik Choon See

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 8/2017

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Abstract

Purpose

Intraprocedural distal embolization is an accepted complication of femoropopliteal angioplasty. The purpose of this study is to assess the use of below-the-knee stents in the “bail-out” of conventional methods.

Materials and Methods

We retrospectively reviewed 1485 of femoropopliteal angioplasties that were performed in our centre in a 4-year period and analysed 12 cases (<1%) where distal embolization that required further intervention occurred. In all cases lesions were chronic and 75% suffered from critical limb ischaemia. The target vessel was the SFA in all of the cases with a long (>10 cm) occlusion in 50%. A three-vessel run-off was present in only 25%. Patients that received a stent as a limb salvage attempt were analysed. Outcome measures were technical success, clinical success and procedure-related complications. Multivariate regression analysis of the factors related to stenting was also performed.

Results

In 41% of the cases with distal embolization, recanalization with aspiration, thrombolysis or angioplasty offered a satisfactory result. In 59%, conventional methods were ineffective; a stent was deployed in 85%, whereas in 15% surgical embolectomy was required. Technical and clinical success of the stent cases was 100% without any procedure-related complications. There was significance (p < 0.05) between critical limb ischaemia and stenting; single-vessel run-off has also shown a positive trend (p = 0.88).

Conclusion

Stents appear as a valid salvage option for infragenicular distal embolization when conventional methods fail; the likelihood of having to use a stent is higher for patients with critical limb ischaemia and a single-vessel run-off.
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Metadaten
Titel
Intraprocedural Distal Embolization After Femoropopliteal Angioplasty: Is There a Role for Below-the-Knee Stents?
verfasst von
Miltiadis Krokidis
Tariq Ali
Nicholas Hilliard
Nadeem Shaida
Andrew Winterbottom
Brendan Koo
Teik Choon See
Publikationsdatum
08.03.2017
Verlag
Springer US
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 8/2017
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-017-1621-5

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