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Case Examples

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Following initial roadmapping, the physician may diagnose a potential threat to distal embolization in the vessel. PROTEUS can be a very useful tool as a primary PTA of the lesion, while capturing and removing the embolic material through its proprietary suction mechanism.

Acute, totally occluded long ISR lesion in the left SFA. A femoral crossover approach using a 7Fr introducer sheath was taken. During roadmapping, the proximal segment showed evidence of irregular flow. A 6x100mm PROTEUS device was used for angioplasty and debris removal (2min @ 8 atm) through its suction mechanism. The distal SFA was treated with a standard PTA balloon. Post angiography revealed a patent vessel with no distal embolic events. Analysis of the removed particles showed evidence of chronic thrombus.

Following primary atherectomy, the lesion may show evidence of irregular vessel wall with or without compromised flow phenomena. PROTEUS can be used for vessel dilatation and the removal of residual embolic debris from the lesion site.

A right, long, heavily calcified, SFA chronic total occlusion was treated with a Turbohawk atherectomy device.  Post angiography revealed irregular vessel wall with slow flow patterns in its mid section.  A 6x100mm PROTEUS device was prepped and deployed (2min @ 8atm) followed by embolic capture and removal through its suction mechanism. Lesion outflow and distal perfusion were significantly improved with no vessel dissection or distal embolic events recorded. A large thrombotic mass (>10mm) and multiple smaller particles were recorded during examination of the removed device.

Endovascular interventions may cause particles dislodgement that can lead to distal embolization. PROTEUS can be an effective tool to contain and remove released particles.

The patient was identified with a long 90% stenotic ISR SFA lesion and moderately diffused posterior and anterior tibial (ATA) arteries. Laser atherectomy was used to ablate the SFA. Post angiography revealed a patent SFA with an abrupt ‘cutoff’ in the proximal segment of the ATA. A 4x100mm PROTEUS device was prepped, crossed and inflated to 10 atm. PROTEUS was then deflated to 2 atm, folded and deflated creating a suction effect for embolic removal. A 3mm atheromatous plaque was noted within the confines of the device upon extraction. Completion angiography showed a patent popliteal and two vessel run-offs with improved perfusion to the foot.

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