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Related Experiment Videos

Distal embolization during lower extremity endovascular interventions.

Cassius I Ochoa Chaar1, Fatma Shebl2, Bauer Sumpio1

  • 1Section of Vascular Surgery, Department of Surgery, Yale School of Medicine, New Haven, Conn.

Journal of Vascular Surgery
|April 4, 2017
PubMed
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Distal embolization (DE) during lower extremity endovascular interventions (LEIs) occurs in 1-2% of cases, particularly in critical limb ischemia patients. Treatment strategies like stenting or angioplasty can significantly reduce DE risk.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Interventions

Background:

  • Distal embolization (DE) is a known complication of peripheral arterial endovascular interventions.
  • The incidence, risk factors, and impact of DE on outcomes remain understudied, particularly in lower extremity interventions.

Purpose of the Study:

  • To determine the incidence of DE during lower extremity endovascular interventions (LEIs).
  • To identify risk factors associated with DE.
  • To evaluate the effect of DE on LEI outcomes, including patency, limb loss, and mortality.

Main Methods:

  • Retrospective review of 10,875 LEIs from the Vascular Study Group of New England (VSGNE) database (2010-2014).
  • Analysis of patient characteristics and procedural details to identify DE predictors.

Related Experiment Videos

  • Multivariable regression analysis to assess the association between treatment type and DE, and the impact of DE on outcomes.

    • Main Results:

    • The overall incidence of DE was 1.73% (17.3 per 1000 procedures), with 68% requiring further treatment.
    • DE was more frequent in patients with critical limb ischemia (RR 2.06) and emergency interventions (RR 2.98).
    • Increased DE risk correlated with the number of treated arteries and occlusion length; stenting and angioplasty alone or combined significantly reduced DE risk compared to atherectomy.

    Conclusions:

    • DE occurs in 1-2% of LEIs, often requiring additional interventions.
    • Critical limb ischemia and atherectomy are associated with increased DE incidence.
    • Specific endovascular techniques like stenting and angioplasty can mitigate DE risk.