Coronary stenting with MGuard: extended follow-up of first human trial

Cardiovasc Revasc Med. 2011 May-Jun;12(3):138-146. doi: 10.1016/j.carrev.2010.06.009. Epub 2010 Oct 20.

Abstract

Objectives: To evaluate feasibility and safety of MGuard based percutaneous coronary interventions (PCI) in vein grafts (VG) and native coronaries (NC).

Background: Distal embolization is a frequent complication of PCI of VG and NC during acute coronary syndromes (ACS). MGuard was a stent designed to reduce embolization.

Methods: Prospective, single arm, two-center trial assessing the feasibility and safety of MGuard-based PCI with post-PCI clinical and laboratory monitoring including: cardiac biomarkers, ECG and 6-month angiography.

Results: Forty-one patients with mean age of 68.2±10.1 years were enrolled. Mean VG age (n=23) was 14.4±4.3 years. All patients received heparin, clopidogrel and aspirin; while none received glycoprotein IIb/IIIa inhibitors, or embolic protection device (EPD). Device and procedural success were 100% and 95.1% respectively. Two patients (4.9%) experienced procedure-related creatinine phosphokinase rise. At 6 months one patient had myocardial infarction and 19.5% had target vessel revascularization (TLR). Late follow up (12-27 months) revealed one additional TLR.

Conclusion: MGuard based PCI of NC and VG appears encouraging especially in view of unfavorable patient and lesion characteristics. Efficacy needs to be further established in larger randomized trials.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary / adverse effects
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Anticoagulants / therapeutic use
  • Biomarkers / blood
  • Coronary Angiography
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Disease / surgery
  • Coronary Artery Disease / therapy*
  • Creatine Kinase / blood
  • Electrocardiography
  • Embolism / etiology
  • Feasibility Studies
  • Female
  • Germany
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / therapy*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Myocardial Infarction / etiology
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prospective Studies
  • Prosthesis Design
  • Stents*
  • Thrombosis / etiology
  • Time Factors
  • Treatment Outcome

Substances

  • Anticoagulants
  • Biomarkers
  • Platelet Aggregation Inhibitors
  • Creatine Kinase