Morrissey N J
Department of Clinical Surgery Columbia University College of Physicians and Surgeons, The New York Presbyterian Hospital, New York, NY 10032, USA.
J Cardiovasc Surg (Torino). 2012 Apr;53(2):173-5.
Distal embolization (DE) during lower extremity arterial intervention is a potentially devastating complication which could lead to limb loss. The use of a distal embolic protection device (EP) may prevent significant DE during intervention. Studies investigating the incidence and impact of DE suggest that it is a rare event with low impact on clinical outcomes. The use of EP during peripheral interventions has only been studied in uncontrolled small series with no comparison to unprotected interventions. In spite of the absence of good quality studies, there may be situations where EP is helpful. These situations may be when lesions or devices are particularly prone to produce emboli. The EP device may produce its own serious complications which must be considered prior to their use. In addition these devices are fairly expensive, a factor that needs to be considered when deciding to employ EP. A simple direct comparison of EP vs. no EP during lower extremity intervention could answer many clinical questions surrounding this controversy.
下肢动脉介入治疗期间的远端栓塞（DE）是一种潜在的毁灭性并发症，可能导致肢体丧失。使用远端栓子保护装置（EP）可在介入治疗期间预防严重的DE。关于DE的发生率和影响的研究表明，这是一种罕见事件，对临床结果影响较小。在外周介入治疗中使用EP仅在未设对照的小样本系列中进行过研究，且未与未使用保护装置的介入治疗进行比较。尽管缺乏高质量研究，但在某些情况下EP可能会有帮助。这些情况可能是病变或装置特别容易产生栓子时。EP装置本身可能会产生严重并发症，在使用前必须予以考虑。此外，这些装置相当昂贵，这是决定是否采用EP时需要考虑的一个因素。在下肢介入治疗期间对EP与不使用EP进行简单的直接比较可以回答围绕这一争议的许多临床问题。
