Abstract
1. Distal embolic protection devices have been developed to reduce the rates of periprocedural complications in arterial interventions. (a) Disruption of occlusive plaque or thrombus during arterial intervention can lead to downstream embolization and microvascular obstruction. (b) Embolic debris usually consists of platelets, red blood cells, infl ammatory cells, extracellular matrix, and cholesterol. (c) Clinical consequences of distal embolization depend on the affected tissue and include cerebral and myocardial injury, renal failure, and acute limb ischemia.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Bibliography
Dubel GJ, Murphy TP. Distal embolic protection for renal arterial interventions. Cardiovascular and Interventional Radiology 2008;31:14–22. ® This review article describes embolic protection devices used in renal interventions and succinctly discusses published outcomes in renovascular interventions with and without their use.
Roffi M, Mukherjee D. Current role of embolic protection devices in percutaneous coronary and vascular interventions. American Heart Journal 2009;157:263–70. ® This article outlines the stages in development of embolic protection devices and summarizes the rationale for their use in cerebrovascular, coronary and peripheral arterial interventions.
Cooper CJ, Haller ST, Colyer W, et al. Embolic protection and platelet inhibition during renal artery stenting. Circulation 2008;117:2752–2760. ® This is the only published randomized trial designed to evaluate the benefit of distal embolic protection and platelet inhibition in renovascular interventions.
Kastrup A, Groschel K, Krapf H, et al. Early outcome of carotid angioplasty and stenting with and without cerebral protection devices: a systematic review of literature. Stroke 2003; 34:813–9. ® This systematic literature review compared reported CAS outcomes with and without DEP and paved the way towards widespread acceptance of DEP in carotid interventions.
Clair DG, Hopkins LN, Mehta M, Kasirajan K, Schermerhorn M, Schonholz C, Kwolek CJ, Eskandari MK, Powell RJ, Ansel GM. Neuroprotection during carotid artery stenting using the GORE flow reversal system: 30-Day outcomes in the EMPiRE clinical study. Catheter Cardiovasc Interv 2011; 77:420–429. ® Proximal protection devices are the most recent addition to the armamentarium of carotid interventions. This trial describes procedural outcomes using the GORE flow reversal proximal protection system.
Ansel GM, Hopkins LN, Jaff MR, Rubino P, Bacharach JM, Scheinert D, Myla S, Das T, Cremonesi A. Safety and effectiveness of the INVATEC MO.MA proximal cerebral protection device during carotid artery stenting: results from the ARMOUR pivotal trial. Catheter Cardiovasc Interv. 2010; 76:1–8. ® This article describes results from the pivotal trial investigating outcomes of carotid stenting using the second proximal protection system approved for clinical use.
Lam RC, Shah S, Faries PL et al. Incidence and clinical significance of distal embolization during percutaneous interventions involving the superficial femoral artery. J. Vascular Surgery 2007;46:1155–1159. ® This study used ultrasound to detect distal embolization during various stages of infrainguinal interventions and correlated these events to clinical outcomes.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Moukarbel, G.V., Sobieszczyk, P.S. (2012). Embolic Protection Devices. In: Owens, C., Yeghiazarians, Y. (eds) Handbook of Endovascular Peripheral Interventions. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-0839-0_5
Download citation
DOI: https://doi.org/10.1007/978-1-4614-0839-0_5
Published:
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4614-0838-3
Online ISBN: 978-1-4614-0839-0
eBook Packages: MedicineMedicine (R0)