Use of Embolic Capture Angioplasty for the Treatment of Occluded Superficial Femoral Artery Segments

Treatment of peripheral chronic total occlusion (CTO) is one of the most challenging lesion subsets in peripheral re-vascularization. Advanced wire technology, novel re-entry catheters and imaging techniques help in crossing such lesions. Subintimal dissection using blunt microdissection devices along with true lumen re-entry techniques have added to the success rates of treating peripheral CTOs. After crossing the occlusion, balloon angioplasty and the placement of self-expanding nitinol stents are usually performed. Peripheral embolization is a known complication of peripheral artery interventions, leading to significant lower-extremity ischemia and complications. Such interventions of peripheral CTOs have been shown to have higher rates of distal embolization. Though no dedicated distal embolic protection strategies are currently available for lower-extremity interventions, use of debris capture angioplasty balloon (Proteus T) may be a feasible alternative. We report 3 cases where this device has been used during recanalization of peripheral CTOs.