Published in:
01-08-2003 | Clinical Investigations
Frequent Embolization in Peripheral Angioplasty: Detection with
an Embolism Protection Device (AngioGuard) and Electron
Microscopy
Authors:
Claudius W. König, Benjamin Pusich, Gunnar Tepe, Hans-Peter Wendel, Ulrich Hahn, Wilke Schneider, Claus D. Claussen, Stephan H. Duda
Published in:
CardioVascular and Interventional Radiology
|
Issue 4/2003
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Abstract
Purpose: To evaluate the deliverability
and protection capabilities of an embolism protection filter in
angioplasty of peripheral arteries.
Methods: The
Angioguard emboli capture guidewire system was applied in 11 patients
with femoropopliteal lesions (6 stenoses, 3 occlusions, 2 controls).
Data on lesion crossing, flow deceleration and macroembolization were
recorded. Filter membranes were evaluated with scanning electron
microscopy (SEM).
Results: System delivery was
successful in all patients. Primary lesion crossing was feasible in
four of six stenoses; predilatation was required in two of six. Marked
flow deceleration was recorded in six patients. Emboli next to the
filter were detected in each patient with concentric plaques, but could
not reliably be removed with the filter. Downstream macroembolization
was also present in all patients with concentric stenoses, but in none
with chronic occlusion. None of the patients had clinical signs of
ischemia. SEM analysis demonstrated only small particles on control
group filters and non-obliterating fibrinous conglomerates on filters
used in chronic occlusion. Substantial obliteration was seen on several
filters used in stenotic lesions.
Conclusion:
Microembolization of fibrin aggregates is a common incident in balloon
angioplasty of femoropopliteal stenoses. Macroembolization occurred
more frequently than previously reported. The use of embolism
protection filters aided in the detection but not in the removal of
larger emboli.