Objective:Endovascular interventions are often complicated by peripheral embolization.up to 5% of all interventionsup to 10.7% in case of occlusionsgreater 90% in case of atherectomyProblem of distal embolization:acute ischemianeed for thrombolysis or mechanical thrombectomyprolonged hospital stayincreased mortalityAim of study:To evaluate the safety, feasibility and efficacy of embolic protection systems during femoro-popliteal endovascular interventions.

Patient cohort:consecutive patients of the Center for Vascular Diseases, Clinical Center of the Ludwig-Maximilians-University of Munich, Germany52 Pts. (28m, 24f), mean age 70.9 yrs.Stage of disease: pAOD II = 27, CLI = 25Performed interventions:balloon angioplasty: n = 6thrombectomy: n = 15atherectomy: n = 31Embolic protection:Spider-FX filter system by ev3 Inc., 3 - 7mm in sizeGrading of result of embolic protection by degree of emboli within the filter:Grade 0 = no emboli visibleGrade 1 = visible sludgeGrade 2 = single particle > 0.2mmGrade 3 = particles...

Technical results:duration of filter placement: 2.3 min ± 0.4 minsuccessful placement: 100%succesful recovery: 100%, but one nearly failure due to total occlusion of the filter after atherectomy of a calcified lesionSafety:filter related complications: n = 2 (vasospasm)vessel wal damage: n = 0distal embolization before and during filter placement: n = 0distal embolization despite filter usage: n = 0Results of the filter grading:Grade 0: n =6 (Balloon angioplasty n = 6)Grade 1: n = 9Grade 2: n = 14Grade 3: n = 10Grade 4: n =...

Use of embolic protection during femoro-popliteal endovascular intervention is:fastsafewill prevent unexpected embolic events during balloon angioplasty of lesions with unknown age (unknown amount of fresh thrombus)is mandatory during all kinds of directional atherectomystil expensiveWe can recommend italways in case of directional atherectomy, at least if calcification is visiblein case of fast onset of claudication with suspicion of high amount of fresh thrombus within a lesion (no matter if visible in ultrasound or not)in case of rotational or other mechanical thrombectomy proceduresif distal outflow is critical

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