Document Detail


Distal filter protection during percutaneous coronary intervention in native coronary arteries and saphenous vein grafts in patients with acute coronary syndromes.
MedLine Citation:
PMID:  14635379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Giampaolo Pasquetto; Bernhard Reimers; Luca Favero; Salvatore Saccà; Carlo Cernetti; Massimo Napodano; Pietro Piccolo; Pietro Pascotto
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Publication Detail:
Type:  Journal Article    
Journal Detail:
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 
Date Detail:
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    
Other Details:
Languages:  eng     Pagination:  614-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Civic Hospital, Mirano, VE, Italy.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Balloon Occlusion / instrumentation
Biological Markers / blood
Blood Vessel Prosthesis
Coronary Angiography
Coronary Artery Disease / physiopathology,  radiography,  therapy*
Coronary Circulation / physiology
Creatine Kinase / blood
Creatine Kinase, MB Form
Device Removal
Equipment Design
Equipment Safety
Female
Filtration / instrumentation
Follow-Up Studies
Humans
Isoenzymes / blood
Male
Middle Aged
Myocardial Infarction / etiology,  metabolism,  radiography
Nitroglycerin / therapeutic use
Postoperative Complications / etiology,  metabolism,  radiography
Saphenous Vein / radiography,  transplantation*
Severity of Illness Index
Stents
Syndrome
Treatment Outcome
Vasodilator Agents / therapeutic use
Verapamil / therapeutic use
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Isoenzymes; 0/Vasodilator Agents; 52-53-9/Verapamil; 55-63-0/Nitroglycerin; EC 2.7.3.2/Creatine Kinase; EC 2.7.3.2/Creatine Kinase, MB Form

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