Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

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.

Original publication

DOI

10.1016/j.amjcard.2006.09.106

Type

Journal article

Journal

Am J Cardiol

Publication Date

01/03/2007

Volume

99

Pages

603 - 606

Keywords

Aged, Angioplasty, Balloon, Coronary, Coronary Artery Bypass, Coronary Disease, Embolism, Female, Hemofiltration, Humans, Male, Middle Aged, Needs Assessment, Predictive Value of Tests, Radiography, Saphenous Vein