Use of Embolic Protection Devices in Peripheral Interventions

The use of embolic protection devices (EPDs) when treating coronary saphenous vein bypass grafts, performing carotid arterial stenting and treating acute coronary syndromes is well accepted. We will review currently available devices and approaches to reduce distal embolisation, first discussing their uses in carotid interventions and then in vertebral and peripheral vascular interventions.

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Routine Use of Debris Aspiration Before Retrieval of Distal Filter Protection Devices in Carotid Arterial Stenting: Analysis of Captured Debris and Evaluation of Clinical Results

Neurosurgery ◽

10.1227/neu.0b013e3181ef5e85 ◽

2010 ◽

Vol 67 (5) ◽

pp. 1260-1267 ◽

Cited By ~ 12

Author(s):

Takatoshi Sorimachi ◽

Kazuhiko Nishino ◽

Junsuke Shimbo ◽

Kenichi Morita ◽

Yasushi Ito ◽

...

Keyword(s):

Carotid Artery ◽

Cerebral Arteries ◽

Clinical Results ◽

Debris Particles ◽

Protection Systems ◽

Protection Devices ◽

Distal Filter ◽

Carotid Arterial ◽

Arterial Stenting ◽

Method Group

Abstract BACKGROUND: Distal filter protection allows for continuous cerebral perfusion during carotid artery stenting (CAS), although a higher risk of debris migrating into the cerebral arteries compared with other protection systems has been reported. OBJECTIVE: To improve the extent of debris capture, we used routine aspiration of blood located proximal to the filter in the internal carotid artery blood column before retrieval of the filter device. METHODS: Of 71 CAS procedures with distal filter protection, routine aspiration was performed in 41 procedures. The size and number of debris particles in each aspirated blood sample were measured under a stereoscopic microscope in 30 consecutive procedures with routine aspiration. Occurrence of periprocedural neurological events was compared between 41 procedures with routine aspiration and the other 30 without routine aspiration. RESULTS: In the aspirated blood, debris particles ≥500 μm and ≥1000 μm in the longest diameter were observed in 30 (100%) and 28 (93.3%) procedures, respectively. The number of particles ≥1000 μm was significantly larger in the second through fourth blood aspirates vs the first aspirate (P < .05). Occurrence of periprocedural neurological events was significantly less frequent in the routine aspiration group (0 of 41 procedures) than in the conventional method group (7 of 30 procedures) (P < .05). CONCLUSION: The use of routine aspiration during CAS with distal filter protection possibly reduced periprocedural neurological events by increasing the proportion of debris captured. To improve the capture of debris particles, at least 4 repeated aspirations are advisable during each CAS procedure.

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Cost-effectiveness of distal embolic protection for patients undergoing percutaneous intervention of saphenous vein bypass grafts

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2004.05.086 ◽

2004 ◽

Vol 44 (9) ◽

pp. 1801-1808 ◽

Cited By ~ 3

Author(s):

David J. Cohen ◽

Sabina A. Murphy ◽

Donald S. Baim ◽

Tara A. Lavelle ◽

Ronna H. Berezin ◽

...

Keyword(s):

Cost Effectiveness ◽

Saphenous Vein ◽

Percutaneous Intervention ◽

Bypass Grafts ◽

Embolic Protection ◽

Saphenous Vein Bypass ◽

Vein Bypass

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Saphenous vein bypass graft intervention and embolic protection devices: Time for reassessment (and revision of percutaneous coronary intervention guidelines)

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.26638 ◽

2016 ◽

Vol 88 (1) ◽

pp. 84-85

Author(s):

Robert D. Safian

Keyword(s):

Percutaneous Coronary Intervention ◽

Saphenous Vein ◽

Bypass Graft ◽

Coronary Intervention ◽

Embolic Protection ◽

Percutaneous Coronary ◽

Vein Bypass ◽

Protection Devices ◽

Vein Bypass Graft ◽

Saphenous Vein Bypass Graft

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Case-Control Registry of Excimer Laser Coronary Angioplasty Versus Distal Protection Devices in Patients With Acute Coronary Syndromes due to Saphenous Vein Graft Disease

The American Journal of Cardiology ◽

10.1016/j.amjcard.2013.07.015 ◽

2013 ◽

Vol 112 (10) ◽

pp. 1586-1591 ◽

Cited By ~ 13

Author(s):

Giampaolo Niccoli ◽

Flavia Belloni ◽

Nicola Cosentino ◽

Francesco Fracassi ◽

Elena Falcioni ◽

...

Keyword(s):

Acute Coronary Syndromes ◽

Saphenous Vein Graft ◽

Case Control ◽

Vein Graft Disease ◽

Coronary Syndromes ◽

Protection Devices ◽

Distal Protection ◽

Graft Disease ◽

Saphenous Vein Graft Disease ◽

Excimer Laser Coronary Angioplasty

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Perspectives on targeting cardio-vascular diseases through reorientation of activities

10.31234/osf.io/3mc8b ◽

2020 ◽

Author(s):

Atul Agarwal

Keyword(s):

Cardiovascular Diseases ◽

Acute Coronary Syndromes ◽

Vascular Diseases ◽

Peripheral Vascular ◽

Primary And Secondary Prevention ◽

Coronary Syndromes ◽

New Perspective ◽

Cardio Vascular ◽

Underlying Pathology

Cardiovascular diseases include coronary artery, cerebrovascular, renovascular, and peripheral vascular diseases. These vascular diseases are known to present with many serious conditions―which include angina and acute coronary syndromes, strokes, cognitive impairment and dementia, epilepsy, parkinsonism, claudication, erectile dysfunction, renal failure, and hypertension. The underlying pathology for these ailments is atherosclerosis. Since 1950s, we have become increasingly focused on causation and management of cardiovascular diseases, which have strong behavioral components. Primary and secondary prevention remains our long-term goal. This paper discusses a new perspective on targeting cardiovascular diseases through reorientation of activities.

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