Role of embolic protection devices in ostial saphenous vein graft lesions

• Published in: Catheterization and cardiovascular interventions Vol. 80; no. 7; pp. 1120 - 1126
• Main Authors: Abdel-Karim, Abdul-Rahman R., Papayannis, Aristotelis C., Mahmood, Arif, Michael, Tesfaldet T., Rangan, Bavana V., Makke, Lorenza, Banerjee, Subhash, Brilakis, Emmanouil S.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.12.2012; Wiley Subscription Services, Inc
• Subjects: Aged; bypass grafts coronary (GRFT); Chi-Square Distribution; Coronary Angiography; Coronary Artery Bypass - adverse effects; Coronary Artery Bypass - mortality; Device Removal; Embolic Protection Devices; embolization (EMBO); Female; Graft Occlusion, Vascular - diagnostic imaging; Graft Occlusion, Vascular - etiology; Graft Occlusion, Vascular - mortality; Graft Occlusion, Vascular - therapy; Heart Arrest - etiology; Humans; Male; Middle Aged; percutaneous coronary intervention (PCI); Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - instrumentation; Percutaneous Coronary Intervention - mortality; Prosthesis Design; Retrospective Studies; Saphenous Vein - diagnostic imaging; Saphenous Vein - transplantation; Stents; Thrombosis - etiology; Time Factors; Treatment Outcome
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.23471

Background Although embolic protection devices (EPDs) have been shown to be beneficial in saphenous vein graft (SVG) lesions, their role in the subgroup of ostial SVG lesions has received limited study. Methods The coronary angiograms and procedural outcomes of 109 patients undergoing stenting of 113 ostial SVG lesions were retrospectively reviewed to determine the frequency of EPD use and the periprocedural outcomes. Results Ninety‐eight (87%) of the 113 lesions were suitable for EPD use, that was used in 70 lesions (71%). A Filterwire (Boston Scientific) or a SPIDER (ev3) filter were used in 54 (77%) and 16 (23%) of lesions, respectively. Difficulty retrieving the filter post stenting was encountered in eight lesions (11%) and led to stent thrombosis causing cardiac arrest in one patient (1%). Angiographic success was achieved in 111 (98%) of 113 lesions. Conclusions EPDs can be utilized in the majority of ostial SVG lesions, but in 11% of cases filter retrieval can be challenging and may rarely (in approximately 1%) lead to a significant complication. © 2012 Wiley Periodicals, Inc.