Temporal reverse flow by proximal femoral artery occlusion during drug-coated balloon dilatation: a technique to minimize downstream particle embolization and systemic adverse effects

• Published in: Journal of vascular surgery cases and innovative techniques Vol. 7; no. 4; pp. 763 - 767
• Main Authors: Kimura, Masayoshi, Shiraishi, Jun, Hyogo, Masayuki, Sawada, Takahisa
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.12.2021; Elsevier
• Subjects: Critical limb ischemia; Downstream embolization; Drug-coated balloon; Innovative technique; Peripheral artery disease; Superficial femoral artery; Superficial femoral artery; Drug-coated balloon; Peripheral artery disease; Critical limb ischemia; Downstream embolization
• ISSN: 2468-4287; 2468-4287
• DOI: 10.1016/j.jvscit.2021.10.001

Downstream paclitaxel particle embolization for nonhealing ischemic ulcers and systemic adverse effects caused by a paclitaxel drug-coated balloon are of concern, and safety measures to prevent these adverse risks are needed. To reduce distal particle embolization and movement of the paclitaxel particles to systemic blood flow during drug-coated balloon inflation, proximal balloon occlusion using a sheathless temporary occlusion balloon-guiding catheter and extraction by manual aspiration of the paclitaxel-containing blood through the catheter are good treatment options to overcome these risks. Here, we introduce this method with tips and tricks, and demonstrate initial experience of this technique.