Distal Embolization of Calcified Nodules and Cholesterol Crystals After JETSTREAM Atherectomy for Femoropopliteal Lesion, Identified by Pathology and MicroCT

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Autori principali: Shunsuke Kojima, Tatsuya Nakama, Sho Torii, Kotaro Obunai
Natura: Artículo Open Access
Pubblicazione: Wiley 2025
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author Shunsuke Kojima
Tatsuya Nakama
Sho Torii
Kotaro Obunai
author_facet Shunsuke Kojima
Tatsuya Nakama
Sho Torii
Kotaro Obunai
Shunsuke Kojima
Tatsuya Nakama
Sho Torii
Kotaro Obunai
collection Wiley Open Access
contents Distal Embolization of Calcified Nodules and Cholesterol Crystals After JETSTREAM Atherectomy for Femoropopliteal Lesion, Identified by Pathology and MicroCT Shunsuke Kojima Tatsuya Nakama Sho Torii Kotaro Obunai Catheterization and Cardiovascular Interventions ABSTRACT Atherectomy devices are often utilized to treat heavily calcified peripheral arterial lesions; however, these procedures carry a risk of distal embolization. A 57‐year‐old patient on hemodialysis underwent JETSTREAM Atherectomy for a heavily calcified superficial femoral artery lesion. Despite successful debulking and drug‐coated balloon angioplasty, distal embolization occurred, leading to irreversible toe ischemia and subsequent amputation. Micro‐computed tomography and histology of the amputated specimen revealed embolized nodular calcification and cholesterol crystals, confirming plaque‐derived debris as the cause. This is the first report to demonstrate such emboli using both modalities. The case underscores the limitations of built‐in aspiration and highlights the importance of careful patient selection, procedural planning, and consideration of embolic protection in complex femoropopliteal interventions. 10.1002/ccd.70068 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1002/ccd.70068
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spellingShingle Distal Embolization of Calcified Nodules and Cholesterol Crystals After JETSTREAM Atherectomy for Femoropopliteal Lesion, Identified by Pathology and MicroCT
Shunsuke Kojima
Tatsuya Nakama
Sho Torii
Kotaro Obunai
Catheterization and Cardiovascular Interventions
Distal Embolization of Calcified Nodules and Cholesterol Crystals After JETSTREAM Atherectomy for Femoropopliteal Lesion, Identified by Pathology and MicroCT Shunsuke Kojima Tatsuya Nakama Sho Torii Kotaro Obunai Catheterization and Cardiovascular Interventions ABSTRACT Atherectomy devices are often utilized to treat heavily calcified peripheral arterial lesions; however, these procedures carry a risk of distal embolization. A 57‐year‐old patient on hemodialysis underwent JETSTREAM Atherectomy for a heavily calcified superficial femoral artery lesion. Despite successful debulking and drug‐coated balloon angioplasty, distal embolization occurred, leading to irreversible toe ischemia and subsequent amputation. Micro‐computed tomography and histology of the amputated specimen revealed embolized nodular calcification and cholesterol crystals, confirming plaque‐derived debris as the cause. This is the first report to demonstrate such emboli using both modalities. The case underscores the limitations of built‐in aspiration and highlights the importance of careful patient selection, procedural planning, and consideration of embolic protection in complex femoropopliteal interventions. 10.1002/ccd.70068 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Distal Embolization of Calcified Nodules and Cholesterol Crystals After JETSTREAM Atherectomy for Femoropopliteal Lesion, Identified by Pathology and MicroCT
topic Catheterization and Cardiovascular Interventions
url https://onlinelibrary.wiley.com/doi/10.1002/ccd.70068