Revascularization for critical limb ischemia using the SpiderFX embolic protection device in the below-the-knee circulation: initial results

J Vasc Interv Radiol. 2014 Oct;25(10):1533-8. doi: 10.1016/j.jvir.2014.07.016. Epub 2014 Aug 22.

Abstract

Purpose: To examine the safety and efficacy of the SpiderFX embolic protection device (EPD) in the below-the-knee (BTK) circulation in patients with critical limb ischemia (CLI).

Materials and methods: A single-center retrospective review was performed to identify patients with CLI and single-vessel runoff in whom the SpiderFX EPD was used in the BTK circulation. Technical success and device-related complications were the primary endpoints. Retrieval of macroscopic debris in the EPD, 1-year freedom from major adverse limb events (MALEs), and 30-day perioperative death were also evaluated. A major amputation, surgical bypass, endovascular thrombectomy, or endovascular thrombolysis was considered a MALE. Thirty-six patients (21 men; mean age, 75.8 y) treated between 2008 and 2013 had endovascular revascularization with use of the SpiderFX EPD in the BTK circulation.

Results: The SpiderFX EPD was successfully deployed in all cases; the technical success rate of revascularization was 100%. Two minor and zero major complications were observed related to the SpiderFX. Two MALEs, a major amputation and a subsequent surgical bypass, were observed in the cohort. All MALEs occurred within 1 year of treatment (1-y freedom from MALE rate, 90%). Debris was retrieved in the SpiderFX device in 47% of patients.

Conclusions: The use of the SpiderFX EPD in the BTK circulation in patients with CLI is safe and frequently retrieves debris.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amputation, Surgical
  • Critical Illness
  • Embolic Protection Devices*
  • Embolism / etiology
  • Embolism / prevention & control*
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Female
  • Humans
  • Ischemia / diagnosis
  • Ischemia / physiopathology
  • Ischemia / therapy*
  • Leg / blood supply*
  • Limb Salvage
  • Male
  • Middle Aged
  • New York City
  • Prosthesis Design
  • Regional Blood Flow
  • Retreatment
  • Retrospective Studies
  • Risk Factors
  • Thrombectomy
  • Thrombolytic Therapy
  • Time Factors
  • Treatment Outcome