Percutaneous embolectomy by transcatheter aspiration. Work in progress.

Distal embolization occurred in 14 of 339 (4%) attempted percutaneous transluminal angioplasty (PTA) procedures, including five of 225 stenoses (2.2%) and nine of the 81 occlusions (11%) that were crossed successfully in 114 attempts (8%). Transcatheter embolectomy by aspiration through a nontapered large-bore catheter was technically successful in five of six attempts (83%), and was combined with successful PTA in three of five patients. In two patients in whom the clinical result of PTA was considered unsatisfactory, successful transcatheter embolectomy permitted an uncomplicated surgical by-pass procedure to be performed. If clinically significant embolization occurs during PTA, this procedure can be attempted prior to surgical embolectomy as an alternative to local fibrinolytic therapy.