To Protect or Not to Protect? In Lower Extremity Angioplasty Procedures, “Why Not?” is the Question

PROTECT does, though, add another single-center experience to a growing list of similar reports that share like experiences and conclusions: (1) distal emboli are very common during lower extremity percutaneous peripheral interventions (PPI), (2) the use of an embolie protection device (EPD) appears safe and at least feasible during lower extremity PPI, and (3) more clinical data need to be accumulated to fully define the clinical entity of distal embolization and the true role of EPDs during lower extremity PPI. Further complicating the issue at this time is the fact that we have no "gold standard" technology corresponding to cardiac nuclear or magnetic resonance imaging to assess pedal microcirculatory function.\n We have found preprocedure CTA lesion morphology to be helpful in identifying lesions at high risk for distal embolization.