title: Use of embolic protective devices in treating acute arterial occlusions: an interventional radiology and vascular surgery collaborative learning experience.
abstract: A 43-year-old man presented to the emergency department with left leg claudication. CT angiogram confirmed an acute left leg arterial occlusion from a left ventricular thrombus. During intra-arterial thrombolysis, he developed severe abdominal pain and a CT angiogram confirmed an acute occlusive thromboembolism to his left renal artery. Prior to left renal artery intra-arterial embolectomy, temporary intra-arterial occlusion balloons were inflated within his (1) right renal artery to protect this kidney from acute embolism and (2) left iliac artery to protect his left leg from further clot burden. Following the left renal embolectomy, an angiogram demonstrated patent renal arteries, acute occlusion of the right common iliac artery and persistent clot in his left iliac/lower limb. These occlusions were retrieved by surgical embolectomy. Final angiogram demonstrated patent bilateral iliac/lower limb arteries. The patient was discharged on lifelong anticoagulation and remains asymptomatic with bilateral palpable distal pulses and normal serum creatine.
authors.affiliation: Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. jwoodleycook@gmail.com
authors.forename: Joel
authors.initials: J
authors.lastname: Woodley-Cook
authors.forename: Vikram
authors.initials: V
authors.lastname: Prabhudesai
authors.forename: Tony
authors.initials: T
authors.lastname: Moloney
mesh_terms: D000328:Adult; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D003131:Combined Modality Therapy; D017128:Embolectomy; D057505:Embolic Protection Devices; D006801:Humans; D007083:Iliac Artery; D007383:Intermittent Claudication / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D007866:Leg / Q000098:blood supply; D008297:Male; D015641:Radiography, Interventional; D012077:Renal Artery; D013923:Thromboembolism / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures / Q000379:methods*