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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2007 February;166(1):41-7

language: English, Italian

Treatment of a distal embolism during the positioning of a femoro-popliteal endoprosthesis

Ventura M., Mastromarino A., Manno M., Franceschini E., Spartera C.

Department of Vascular Surgery, San Salvatore Hospital, L’Aquila, Italy


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Endovascular surgery has enjoyed a growing level of success in the treatment of femoro-popliteal lesions. The introduction of PTFE endoprostheses with nitinol stents has made re-canalization of even long occlusions possible, with primary and secondary perviety rates at short and medium terms comparable to those of traditional surgery. The main advantage of endovascular surgery is that it is a minimally invasive procedure and even high surgical risk patients, such as those who require peripheral re-vascularization surgery, can benefit from this treatment. However, endovascular surgery is not completely risk-free and one complication that can arise is the peripheral embolisation of plaque fragments with ischaemia of the limb. This complication can sometimes be avoided using endovascular techniques which allow for the successful outcome of the operation. The case we report here is of an occlusive femoro-popliteal lesion treated through the positioning of a Viabahn endoprosthesis. The successful outcome of this operation was threatened by the peripheral embolisation of a plaque fragment. Embolectomy was performed using a Fogarty catheter inserted through a 9Fr sheath, the procedure was monitored by fluoroscopy and the operation completed successfully with total re-vascularization of the limb.

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