Material embolization of the distal arterial channel during endovascular and open revascularization of total occlusions of the superficial femoral artery complemented by drug-coated balloon angioplasty Distal embolism in infrainguinal revascularizations augmented by drug-coated balloon angioplasty.

Aim: The purpose of our clinical study is to compare the incidence of peripheral embolism during endovascular recanalization with a paclitaxel-coated balloon angioplasty versus open endatherectomy with a paclitaxel-coated balloon angioplasty.

Materials and methods: Prospective, randomized, single-center pilot study of patients with superficial femoral artery occlusive lesions. Patients of group 1 (PTA+DCB) underwent recanalization of the superficial femoral artery (SFA) with drug-coated balloon angioplasty. Patients of group 2 (RE+DCB) underwent remote semi-closed endarterectomy from the SFA with drug-coated balloon angioplasty. Doppler emboldetection was performed during the revascularization procedure.

Results: The study included 10 patients in each group. The patients did not differ in age, comorbidity, and severity of lower extremity ischemia. The majority were patients with intermittent claudication. In the PTA+DCB group, the median number of ebmols during the procedure was 200.0 [100.0; 200.0], and in the group RE+DCB 7 [6;8], p= 0.0002. Moreover, in the PTA+DCB group, peripheral embolism occurred both during the passage of the target artery lesion (in 100% of cases) and during drug-coated balloon angioplasty (in 60% of cases), while in the RE+DCB group peripheral embolism occurred only during drug-coated balloon angioplasty (100% of cases).

Conclusion: There was a higher incidence of material distal embolism with PTA+DCB compared with RE+DCB.

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