TORNA ALL’ELENCO

Angiographic improvement in STEMI reperfusion: Preliminary experience with MGuard net protective stent in European Heart Journal

2009
ASL Torino 5
ASL Città di Torino
ASL Cuneo 1

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (10)Vedi tutti...

Piscione F

Danzi GB

Cassese S


et alii...

Abstract

Objectives: Embolisation of atherothrombotic material is common during percutaneous coronary intervention (PCI) in acute myocardial infarction (MI), resulting in larger infarct size and increased mortality. MGuard net protective stent (MGS) is a new concept device for PCI that, through an ultra-thin polymer mesh sleeve attached to the external surface of the stent, aims to protect the microcirculation in ST-segment elevated myocardial infarction (STEMI) setting, by minimizing distal embolisation. We report first clinical experience with MGS, in a consecutive series of STEMI patients. Methods: Baseline clinical and angiographic characteristics have been collected, as well as TIMI antegrade coronary flow and corrected TIMI frame count (cTFC) pre and post PCI procedure; post procedural Myocardial Blush perfusion Grade (MBG), ST-segment resolution at 60 min from PCI, as well as Major Adverse Cardiac Events (MACE) at in hospital and 30 day follow up, were evaluated. MACE included: cardiac death, MI, stent thrombosis, need for target vessel revascularization. Results: Eighty-five consecutive patients (78% Male gender; Mean age 61.4±11.9 years), underwent PCI (32% Rescue; 68% Primary) with MGS deployment for STEMI (Anterior 32%; Non anterior 68%; Cardiogenic shock at admission 16%). All patients underwent successful procedures. At quantitative coronary angiography, pre PCI Minimum lumen diameter was 0.21±0.58 mm with 17.27±7.87 mm lesion length. At Angio, mean TIMI flow grade improved from 0.81±1.22 to 2.85±0.38, mean cTFC (n) from 66.01±34.45 to 17.24±9.60, with a mean ?cTFC (n) of 48.44±38.68 and a 100% final Post PCI 2-3 MBG (94% MBG 3; 6% MBG 2). At 60 min post PCI the ST-segment resolution was total (?70%) in 93% of patients. At in hospital follow up, seven deaths were reported due to: heart rupture with cardiac tamponade (n=1); severe right or left ventricular function impairment (n=3); acute pulmonary distress (n=2); intracranial haemorrhage (n=1).

DOI : 10.1093/eurheartj/ehp415

Keywords

brain hemorrhage; heart left ventricle function; heart tamponade; heart rupture; angiocardiography; gender; coronary artery blood flow; revascularization; heart death; devices; death; ST segment; cardiogenic shock; stent thrombosis; artificial embolization; population; hospital; follow up; patient; reperfusion; society; cardiology; ST segment elevation myocardial infarction; stent; polymer; dissection; percutaneous coronary intervention; acute heart infarction; infarction; mortality; microcirculation; perfusion; male;