Percutaneous management of emboli associated with hot tip laser-assisted angioplasty

We describe the percutaneous management of emboli that occurred in 3 patients during hot tip laser-assisted angioplasty procedures. One embolus was lysed with direct, local infusion of urokinase using an open-ended guidewire. Another embolus was removed using the transcatheter aspiration technique. The third embolus was partially lysed and then, using a steerable guidewire, displaced placed into a distal side branch. In all 3 cases of embolization, distal blood flow was reestablished using percutaneous techniques, obviating the need for surgical intervention.