The Results of a New Distal Protection Method in Intervention for Chronic Total Occlusion of the Superficial Femoral Artery

Aims. To determine the efficacy of a new distal protection method in SFA CTO interventions. Methods and Results. From June 2003 to February 2009, ninety-two consecutive, chronic total occlusions of superficial femoral arteries were treated with catheter-based intervention using a...

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Main Authors: Tomoko Kobayashi, Atsushi Funatsu, Emiko Ejima, Hiromi Muranishi, Makoto Utsunomiya, Kensaku Shibata, Masahiro Mizobuchi, Yoshihisa Enjoji, Shigeru Nakamura
Format: Article
Language:English
Published: Wiley 2009-01-01
Series:Cardiology Research and Practice
Online Access:http://dx.doi.org/10.4061/2009/687609
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author Tomoko Kobayashi
Atsushi Funatsu
Emiko Ejima
Hiromi Muranishi
Makoto Utsunomiya
Kensaku Shibata
Masahiro Mizobuchi
Yoshihisa Enjoji
Shigeru Nakamura
author_facet Tomoko Kobayashi
Atsushi Funatsu
Emiko Ejima
Hiromi Muranishi
Makoto Utsunomiya
Kensaku Shibata
Masahiro Mizobuchi
Yoshihisa Enjoji
Shigeru Nakamura
author_sort Tomoko Kobayashi
collection DOAJ
description Aims. To determine the efficacy of a new distal protection method in SFA CTO interventions. Methods and Results. From June 2003 to February 2009, ninety-two consecutive, chronic total occlusions of superficial femoral arteries were treated with catheter-based intervention using a bidirectional approach. Nine of these cases were managed with our original, distal protection method, based on symptoms, angiographic images, wire resistance, and intravascular ultrasound images. The average age was 73 years; eight patients were male. The mean occlusion length was 17.1 cm. A distal protection balloon was inserted from the retrograde sheath in the popliteal artery and placed distal to the occluded lesion after successful wire crossing. Lesion dilatation with a balloon was performed antegradely and debris was removed by 6Fr. guiding catheter. Debris was retrieved from all lesions, consisting mainly of thrombus. Where we decided not to use the distal protection method, there was no distal thromboembolism. Conclusion. In SFA-CTO intervention, the risk of distal embolization is 10%, which can be anticipated and eliminated by the distal protection method.
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spelling doaj-art-d9b93b0ade054440ad1e458c8dfb16f02025-08-20T03:24:22ZengWileyCardiology Research and Practice2090-05972009-01-01200910.4061/2009/687609687609The Results of a New Distal Protection Method in Intervention for Chronic Total Occlusion of the Superficial Femoral ArteryTomoko Kobayashi0Atsushi Funatsu1Emiko Ejima2Hiromi Muranishi3Makoto Utsunomiya4Kensaku Shibata5Masahiro Mizobuchi6Yoshihisa Enjoji7Shigeru Nakamura8Cardiovascular Center, Kyoto Katsura Hospital, 17 Yamada-Hirao, Nishikyo-ku, Kyoto 615-8256, JapanCardiovascular Center, Kyoto Katsura Hospital, 17 Yamada-Hirao, Nishikyo-ku, Kyoto 615-8256, JapanCardiovascular Center, Kyoto Katsura Hospital, 17 Yamada-Hirao, Nishikyo-ku, Kyoto 615-8256, JapanCardiovascular Center, Kyoto Katsura Hospital, 17 Yamada-Hirao, Nishikyo-ku, Kyoto 615-8256, JapanCardiovascular Center, Kyoto Katsura Hospital, 17 Yamada-Hirao, Nishikyo-ku, Kyoto 615-8256, JapanCardiovascular Center, Kyoto Katsura Hospital, 17 Yamada-Hirao, Nishikyo-ku, Kyoto 615-8256, JapanCardiovascular Center, Kyoto Katsura Hospital, 17 Yamada-Hirao, Nishikyo-ku, Kyoto 615-8256, JapanCardiovascular Center, Kyoto Katsura Hospital, 17 Yamada-Hirao, Nishikyo-ku, Kyoto 615-8256, JapanCardiovascular Center, Kyoto Katsura Hospital, 17 Yamada-Hirao, Nishikyo-ku, Kyoto 615-8256, JapanAims. To determine the efficacy of a new distal protection method in SFA CTO interventions. Methods and Results. From June 2003 to February 2009, ninety-two consecutive, chronic total occlusions of superficial femoral arteries were treated with catheter-based intervention using a bidirectional approach. Nine of these cases were managed with our original, distal protection method, based on symptoms, angiographic images, wire resistance, and intravascular ultrasound images. The average age was 73 years; eight patients were male. The mean occlusion length was 17.1 cm. A distal protection balloon was inserted from the retrograde sheath in the popliteal artery and placed distal to the occluded lesion after successful wire crossing. Lesion dilatation with a balloon was performed antegradely and debris was removed by 6Fr. guiding catheter. Debris was retrieved from all lesions, consisting mainly of thrombus. Where we decided not to use the distal protection method, there was no distal thromboembolism. Conclusion. In SFA-CTO intervention, the risk of distal embolization is 10%, which can be anticipated and eliminated by the distal protection method.http://dx.doi.org/10.4061/2009/687609
spellingShingle Tomoko Kobayashi
Atsushi Funatsu
Emiko Ejima
Hiromi Muranishi
Makoto Utsunomiya
Kensaku Shibata
Masahiro Mizobuchi
Yoshihisa Enjoji
Shigeru Nakamura
The Results of a New Distal Protection Method in Intervention for Chronic Total Occlusion of the Superficial Femoral Artery
Cardiology Research and Practice
title The Results of a New Distal Protection Method in Intervention for Chronic Total Occlusion of the Superficial Femoral Artery
title_full The Results of a New Distal Protection Method in Intervention for Chronic Total Occlusion of the Superficial Femoral Artery
title_fullStr The Results of a New Distal Protection Method in Intervention for Chronic Total Occlusion of the Superficial Femoral Artery
title_full_unstemmed The Results of a New Distal Protection Method in Intervention for Chronic Total Occlusion of the Superficial Femoral Artery
title_short The Results of a New Distal Protection Method in Intervention for Chronic Total Occlusion of the Superficial Femoral Artery
title_sort results of a new distal protection method in intervention for chronic total occlusion of the superficial femoral artery
url http://dx.doi.org/10.4061/2009/687609
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