Filters placed in the superficial femoral arteries for limb salvage in a high-surgical-risk patient with atheroembolism: results at 2 years.
OBJECTIVE
To report the off-label use of Emboshield filters as a treatment for bilateral atheroembolism (trash foot) in an inoperable patient.


METHODS
A 64-year-old man with a juxtarenal abdominal aortic aneurysm (jAAA) presented with necrotic wounds of the forefoot and toes of both feet. Doppler imaging showed triphasic signals. He was on oral anticoagulants because of a mechanical valve. The patient was admitted for evaluation and administration of intravenous antibiotics; other than the jAAA, no other source of emboli was detected. Since the patient was inoperable, Emboshield filters were placed bilaterally through antegrade femoral accesses at the level of the superficial femoral arteries to prevent embolism to the feet. Two years later, the patient has no symptoms; debris is present in both filters but does not compromise arterial flow into the legs.


CONCLUSIONS
This case demonstrates the successful off-label use of an Emboshield filter for trash foot in an inoperable patient.
Van Thielen
Jana
J
Department of Thoracic and Vascular Surgery, University Hospital Antwerp, Edegem, Belgium.
Hendriks
Jeroen M H
JM
Hertoghs
Marjan
M
Lauwers
Patrick
P
Van Schil
Paul
P
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging; D018795:Device Approval; D017700:Embolism, Cholesterol / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D004867:Equipment Design; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005374:Filtration / Q000295:instrumentation*; D005528:Foot / Q000098:blood supply*; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011356:Product Labeling; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014945:Wound Healing
D000900:Anti-Bacterial Agents; D000925:Anticoagulants