Ricerc@Sapienza

The application of advanced endovascular techniques in very complex femoropopliteal atherosclerotic lesions has shown to expose patients to a higher risk of distal embolization (DE). This complication can affect both the short- and long-term outcomes, leading to worsening ischemia, early minor/major amputation, and longer hospital stay. Recently, there has been an increasing body of evidence on pathophysiology and clinical–radiological management of DE that however has not been systematically addressed by guidelines.

Endovascular treatment of peripheral artery disease (PAD) has become the standard of care for TransAtlantic Inter-Society Consensus II A,B patients, although no evidence exists as to which procedures are preferred for each lesion type, and numerous different approaches could be employed.1 The latest trend in this field is to revascularize the limb without stent deployment by means of angio-modeling,2 atherectomy,3 or drug-coated balloon angioplasty.4 Despite these efforts a certain number of patients with relatively short lesions will experience residual stenosis, elastic recoil, or resteno