Purpose: To compare the incidence of distal emboli occurring during percutaneous transluminal angioplasty (PTA) and primary stent on the superficial femoral artery (SFA) Methods: A total of 50 consecutive patients were entered in a prospective, randomized trial. Inclusion criteria were the presence of symptomatic limb ischemia due to stenosis or occlusion of the SFA. An embolic protection device was placed in the popliteal artery. The patients were then randomly assigned to undergo primary stent implantation or PTA. The filters were retrieved and sent for histologic examination. Results: Stenting in the SFA produced more emboli (1.44 mm3) than PTA (0.772 mm3), P = .031. Reanalyzing the patients according to actual treatment performed, volume of debris in the stent group was 1.271 mm3 and in the PTA group was 0.191 mm3, P = .00087. Conclusion: Volume of embolized material during endovascular interventions in the SFA-above-knee popliteal artery is higher when a stent is used.
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