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Efficacy of the novel technique HIRANODOME in preventing distal embolization during endovascular treatment of femoropopliteal lesions
Author(s) -
Fukagawa Tomoya,
Hirano Keisuke,
Mori Shinsuke,
Yamawaki Masahiro,
Kobayashi Norihiro,
Tsutsumi Masakazu,
Honda Yohsuke,
Makino Kenji,
Ito Yoshiaki
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29471
Subject(s) - medicine , embolization , popliteal artery , amputation , surgery , blood flow , thrombus , radiology , femoral artery , lesion , ischemia , occlusion , cardiology
Objectives The efficacy and clinical outcomes of a novel technique “HIRANODOME” (Interim hemostatic technique with HIgh pressure for Regional blood flow in the superficial femoral Artery, NOninvasive Distal protection Occlusion MEthod) in preventing distal embolization during endovascular treatment (EVT) of femoropopliteal lesions were evaluated. Background Distal embolization of femoropopliteal lesions may worsen limb ischemia or cause limb loss. Conventional filter wires are cumbersome and expensive and may cause vessel injury. HIRANODOME can, therefore, be a feasible and noninvasive alternative. Methods Between April 2007 and August 2018, 94 consecutive patients who underwent EVT for femoropopliteal lesions along with anticipated distal embolization were identified. About 9 out of these 94 patients were excluded due to filter device use and 8 were excluded due to acute limb ischemia. Consequently, 77 patients using HIRANODOME for distal protection were included. HIRANODOME involved wrapping the Tometakun around the knee to enable external compression of the popliteal artery, thereby blocking the blood flow. The evaluation items were 30‐day mortality, 30‐day major amputation, prevention from distal embolization, and thrombus capture rate. Results The mean age was 74.4 ± 10.3 years, 53.2% were men, 55.8% were diabetic, and 9.1% were on hemodialysis. The mean lesion length was 199.5 ± 94.4 mm; 79.2% were class C/D lesions (TASC II classification). The 30‐day mortality and major amputation rates were 1.9 and 1.0%, respectively. The rate of prevention of distal embolization or no‐flow/slow‐flow phenomenon was 93.4%. Capture of thrombus was observed in 66 lesions (62.3%). Conclusions The HIRANODOME technique was effective in preventing distal embolization during EVT of femoropopliteal lesions.