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A case of massive distal embolizations occluding every collateral network during percutaneous intervention for

Hidehiko Hara1, Hiroko Toma, Tetsuo Lee

  • 1Minneapolis Heart Institute and Foundation, Minneapolis, MN 55407, USA. harahide@aol.com

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|February 13, 2007
PubMed

Insights

Percutaneous transluminal angioplasty for iliac artery occlusion can cause plaque detachment and embolization. This complication led to limb ischemia and a fatal outcome in one patient.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Radiology

Background:

  • Chronic iliac artery occlusion presents a significant challenge in vascular interventions.
  • Percutaneous transluminal angioplasty (PTA) is a common treatment modality.
  • Collateral circulation plays a crucial role in maintaining limb perfusion.

Observation:

  • A patient with right common iliac artery occlusion underwent PTA.
  • Initial ballooning dislodged plaque, causing embolization to external and internal iliac arteries.
  • This embolization compromised critical collateral flow to the right femoral artery.

Findings:

  • Repeat interventions failed due to embolus displacement and diminished collateral flow.
  • Complete occlusion of the right femoral artery occurred.
  • Surgical embolectomy was successful, but the patient died from myonephropathic metabolic syndrome.

Implications:

  • This case highlights a potentially fatal complication of PTA for chronic iliac artery occlusion.
  • Embolization of dislodged plaque can lead to acute limb ischemia.
  • Careful patient selection and technique are crucial in percutaneous interventions for occlusive arterial disease.

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