The results of a new distal protection method in intervention for chronic total occlusion of the superficial femoral artery

Distal Embolization During Percutaneous Subclavian Artery Intervention

Distal embolization due to atherothrombotic debris during subclavian artery interventions is extremely rare and can usually be managed conservatively. Herein, we describe a case of acute hand ischemia due to massive distal embolization during balloon angioplasty and stenting of a left subclavian artery chronic total occlusion. This limb-threatening complication was effectively treated with rescue surgical thrombectomy.

Use of embolic protective devices in treating acute arterial occlusions: an interventional radiology and vascular surgery collaborative learning experience

A 43-year-old man presented to the emergency department with left leg claudication. CT angiogram confirmed an acute left leg arterial occlusion from a left ventricular thrombus. During intra-arterial thrombolysis, he developed severe abdominal pain and a CT angiogram confirmed an acute occlusive thromboembolism to his left renal artery. Prior to left renal artery intra-arterial embolectomy, temporary intra-arterial occlusion balloons were inflated within his (1) right renal artery to protect this kidney from acute embolism and (2) left iliac artery to protect his left leg from further clot burden. Following the left renal embolectomy, an angiogram demonstrated patent renal arteries, acute occlusion of the right common iliac artery and persistent clot in his left iliac/lower limb. These occlusions were retrieved by surgical embolectomy. Final angiogram demonstrated patent bilateral iliac/lower limb arteries. The patient was discharged on lifelong anticoagulation and remains asymptomatic with bilateral palpable distal pulses and normal serum creatine.