Jia Zhongzhi, Zhao Jinwei, Tian Feng, Wang Kai, Li Shaoqin, Jiang Guomin, Wang Weiping
Department of Interventional Radiography, No. 2 People's Hospital of Changzhou, Nanjing Medical University, Xing Long Road 29#, Chang Zhou, 213003, Jiangsu Province, China.
Department of Radiology, Mayo Clinic, Jacksonville, FL, 32224, USA.
Cardiovasc Intervent Radiol. 2015 Dec;38(6):1444-50. doi: 10.1007/s00270-015-1086-3. Epub 2015 Mar 31.
To retrospectively evaluate the safety and efficacy of the Spider filter embolic protection device (EPD) in protecting patients from distal migration of thromboemboli during revascularization of acute superficial femoral artery (SFA) occlusion secondary to thromboemboli.
Data from all patients at our institution who had EPD placement for embolic protection during endovascular revascularization for acute thromboembolic occlusion of the SFA were analyzed.
From April 2007 to June 2014, a total of 14 patients had EPD placement during endovascular revascularization for acute SFA occlusion secondary to thromboemboli. All patients presented with acute onset of limb ischemia, and further work-up with imaging studies demonstrated thromboembolic occlusions. The duration from onset of symptoms to revascularization was 7.0 ± 2.7 h (range 2-14 h). An aspiration technique for thrombectomy was used in all 14 cases (aspiration alone, 6 cases; aspiration plus urokinase, 7 cases; additional angioplasty after urokinase, 1 case). Spider filter EPDs were successfully placed at the target in all 14 cases, and the thromboemboli were captured in 13/14 (92.9%) cases. Successful reestablishment of the SFA flow without distal branch embolism occurred in all 14 cases. There were no EPD-related complications. During a mean 32.2 ± 20.2 months of follow-up, 13 patients remained asymptomatic; one patient who underwent PTA during the procedure reported limb coolness and fatigue 6 months later because of recurrent atherosclerotic stenosis.
The Spider filter EPD can be safe and effective in protecting patients from distal branch embolism when they undergo an endovascular thrombectomy procedure.
