Document Detail

Prediction of distal embolization during percutaneous coronary intervention in saphenous vein grafts.
MedLine Citation:
PMID:  17317357     Owner:  NLM     Status:  MEDLINE    
Distal protection devices have been proved to decrease distal embolization and improve outcome in unselected patients undergoing percutaneous coronary intervention (PCI) in saphenous vein grafts (SVGs). However, it remains uncertain whether distal protection is necessary in all patients. We investigated whether clinical or angiographic variables can predict distal embolization and, hence, need for a distal protection device. Fifty-eight consecutive SVGs that underwent PCI with a FilterWire distal protection device were studied. After the procedure, the FilterWire was fixed in formalin and photographed, and embolic debris area (square millimeters) was quantified by semi-automated edge-detection analysis. Debris area was correlated with 6 prespecified variables: clinical presentation, SVG age, reference lumen diameter, plaque volume, SVG degeneracy, and presence of a filling defect. Embolic debris was identified in 57 of 58 grafts (98%). Median debris area was 4.0 mm(2) (range 0.0 to 25.1). None of the prespecified variables predicted the occurrence of distal embolization or the amount of captured embolic debris. In conclusion, distal embolization during SVG PCI is universal. Embolic burden cannot be predicted by clinical or angiographic variables, and embolic protection should be used in all patients.
William Joseph van Gaal; Robin Patrick Choudhury; Italo Porto; Keith Channon; Adrian Banning; Vladimir Dzavik; Rachael Ramsamujh; Sanh Bui; Daniel James Blackman
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Publication Detail:
Type:  Journal Article     Date:  2007-01-04
Journal Detail:
Title:  The American journal of cardiology     Volume:  99     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-23     Completed Date:  2007-04-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  603-6     Citation Subset:  AIM; IM    
Department of Cardiology, John Radcliffe Hospital, Oxford, UK.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Coronary Artery Bypass
Coronary Disease / radiography,  therapy*
Embolism / etiology*,  prevention & control,  radiography
Hemofiltration / instrumentation
Middle Aged
Needs Assessment
Predictive Value of Tests
Saphenous Vein / radiography,  transplantation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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