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Online ISSN 1827-1847
LOWER EXTREMITIES HOT TOPICS
Cafasso D. 1, Schneider P. 2
1 Department of Surgery, Tripler Army Medical Center, Honolulu, HI, USA;
2 Division of Vascular Therapy, Hawaii Permanente Medical Group and Kaiser Foundation Hospital, Honolulu, HI, USA
Embolic protection devices have the potential to make complex lower extremity endovascular interventions safer. The utility and success of distal embolic protection devices in the coronary and carotid vasculature have prompted the exploration as to whether such devices may evolve to prevent distal embolization in the lower extremity. There are no substantially powered, prospective, multicenter, randomized trials to prove or disprove the effectiveness and benefit of such devices over the associated risks. However, observational and experiential data are accumulating which provide clues as to the usefulness of this approach. This review presents an overview of the current literature as well as an argument for the use of distal embolic protection devices in selected patients during endovascular treatment of infrainguinal occlusive disease. The types of filters as well as the technique for filter use are described. Pitfalls and associated recommendations to overcome these circumstances are included.