|Distal filter protection during percutaneous coronary intervention in native coronary arteries and saphenous vein grafts in patients with acute coronary syndromes.|
|PMID: 14635379 Owner: NLM Status: MEDLINE|
|BACKGROUND: Percutaneous coronary interventions on saphenous vein grafts (SVG) and in patients with acute coronary syndromes (ACS) have been associated with the distal embolization of the thrombus and plaque and to the no-reflow phenomenon. We report on the safety and feasibility of a new distal emboli protection filter. METHODS: Angioplasty using distal filter protection (Angioguard, Cordis, Warren, NJ, USA) was attempted in 38 patients (mean age 65 +/- 11 years, 79% males) affected by ACS. A percutaneous coronary intervention was performed in 27 native coronary arteries, in 10 SVG and in one arterial graft (mean diameter stenosis 88 +/- 9%). Patients with vessels presenting severe proximal tortuosity, more than mild calcification, a diameter < 3.0 mm and a lesion length > 15 mm were excluded. RESULTS: It was possible to position the device in all patients (100%); in 7 patients (18%) the lesion could be crossed with the filter only after balloon predilation. Procedural success with final TIMI flow 3 was obtained in all patients and the mean residual diameter stenosis after stent implantation was 5 +/- 8%. Transient procedural complications without clinical sequelae included the no-reflow phenomenon (2 patients, 5%) and vessel perforation (1 patient, 2.5%). In no case was distal embolization observed. As regards the device-related complications, one occlusive dissection (2.5%) occurred and was successfully treated with stent implantation. In-hospital and 30-day major adverse cardiac events consisted of two non-Q wave myocardial infarctions (5%), both occurring during SVG interventions. CONCLUSIONS: The use of the Angioguard filter for preselected lesions in patients with ACS had a high technical success and carried a low rate of device-related complications. The clinical efficacy of the device needs further evaluation.|
|Giampaolo Pasquetto; Bernhard Reimers; Luca Favero; Salvatore Saccà; Carlo Cernetti; Massimo Napodano; Pietro Piccolo; Pietro Pascotto|
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|Type: Journal Article|
|Title: Italian heart journal : official journal of the Italian Federation of Cardiology Volume: 4 ISSN: 1129-471X ISO Abbreviation: Ital Heart J Publication Date: 2003 Sep|
|Created Date: 2003-11-25 Completed Date: 2004-03-26 Revised Date: 2007-11-15|
Medline Journal Info:
|Nlm Unique ID: 100909716 Medline TA: Ital Heart J Country: Italy|
|Languages: eng Pagination: 614-9 Citation Subset: IM|
|Department of Cardiology, Civic Hospital, Mirano, VE, Italy.|
|APA/MLA Format Download EndNote Download BibTex|
Angioplasty, Transluminal, Percutaneous Coronary*
Balloon Occlusion / instrumentation
Biological Markers / blood
Blood Vessel Prosthesis
Coronary Artery Disease / physiopathology, radiography, therapy*
Coronary Circulation / physiology
Creatine Kinase / blood
Creatine Kinase, MB Form
Filtration / instrumentation
Isoenzymes / blood
Myocardial Infarction / etiology, metabolism, radiography
Nitroglycerin / therapeutic use
Postoperative Complications / etiology, metabolism, radiography
Saphenous Vein / radiography, transplantation*
Severity of Illness Index
Vasodilator Agents / therapeutic use
Verapamil / therapeutic use
|0/Biological Markers; 0/Isoenzymes; 0/Vasodilator Agents; 52-53-9/Verapamil; 55-63-0/Nitroglycerin; EC 220.127.116.11/Creatine Kinase; EC 18.104.22.168/Creatine Kinase, MB Form|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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