Author + information
- Houman Khalilia,b,
- Haekyung Jeon-Slaughtera,b,
- Ishita Tejania,b,
- Amutharani Baskara,b,
- Ehrin Armstronga,b,
- Nicolas Shammasa,b,
- Andrew Shammasa,b,
- Anand Prasada,b,
- Ian Cawicha,b,
- Gerardo Rodrigueza,b,
- Mazen Abu-Fadela,b,
- Emmanouil Brilakisa,b and
- Subhash Banerjeea,b
Background: Distal embolization (DE) is a serious complication of lower extremity peripheral vascular interventions (PVI). Although, embolic protection devices (EPD) mitigate the risk of DE, there is a paucity of data on the use of EPDs during PVI.
Methods: We analyzed data from the multicenter Excellence in Peripheral Artery Disease (XLPAD) registry (NCT01904851) to establish patient and lesion characteristics associated with EPD use. We included 2,353 infrainguinal PVIs from 1,907 patients between January 2005 and October 2015.
Results: The mean age was 66.1±9.8 years, with pre-procedure mean Rutherford category 3.3±1.1 and mean ankle-brachial index 0.68±0.23. EPDs were used during 23% of PVIs; 89% of EPDs were used with atherectomy and 33% without (p<0.0001; Figure 1a). EPD use was more frequent in target vessels with larger diameters (4.6±0.3 mm vs. 4.5±0.4 mm; p<0.0001), and longer lesion lengths (105±25 mm vs. 100±25mm; p<0.0001). EPD use was associated with a lower rate of clinically significant DE (2.2% vs. 1.3%; p=0.01; Figure 1b). Within the atherectomy group, EPD use was 44.5%, and its use was more frequent in chronic total occlusions and with Turbohawk™ and Jetstream™ devices. However, presentation with critical limb ischemia, severity of vessel calcification, or numbers of below the knee run-off vessels were not associated with EPD use.
Conclusions: EPD is used in less than a quarter of all PVIs, and in less than half of all atherectomy procedures. EPD use, however, resulted in a lower rate of DE.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Head to Toe: Outcomes of Endovascular Interventions
Abstract Category: 18. Interventional Cardiology: Carotid and Endovascular Intervention
Presentation Number: 1112-118
- 2017 American College of Cardiology Foundation