TY - JOUR
T1 - Prevention of distal embolization during saphenous vein graft lesion angioplasty
T2 - Experience with a new temporary occlusion and aspiration system
AU - Carlino, Mauro
AU - De Gregorio, Joseph
AU - Di Mario, Carlo
AU - Anzuini, Angelo
AU - Airoldi, Flavio
AU - Albiero, Remo
AU - Briguori, Carlo
AU - Dharmadhikari, Aniruddha
AU - Sheiban, Imad
AU - Colombo, Antonio
PY - 1999/6/29
Y1 - 1999/6/29
N2 - Background - Repeat coronary artery bypass graft surgery (CABG) is associated with a high morbidity and mortality, rendering percutaneous treatment of saphenous vein graft (SVG) lesions an attractive alternative. However, percutaneous interventions of degenerated SVGs carries high risk of distal embolization. Methods and Results - This study reports our initial experience with the PercuSurge GuardWire, a new device developed to prevent embolization during treatment of degenerated SVG. This device consists of a 190-cm-long, hollow 0.014-in guidewire with a central lumen connected to a distal occlusion balloon. A dedicated inflation device (the MicroSeal Adapter) was used to inflate the distal balloon and maintain complete lumen occlusion during balloon dilatation and stent implantation. A monorail aspiration catheter, connected to a vacuum syringe, was used to evacuate atherosclerotic and thrombotic debris. Angioplasty with stent implantation was performed in 15 degenerated SVGs (18 lesions). Procedural success was achieved in all patients with normal postprocedure flow (Thrombolysis in Myocardial Infarction grade 3). No distal embolization was observed. There were no major in-hospital adverse clinical events, including Q-wave or non- Q-wave myocardial infarction, emergency CABG, or death. All patients were asymptomatic at discharge. Conclusions - This preliminary series supports the feasible use of the PercuSurge GuardWire for retrieval of plaque debris and prevention of embolization in degenerated SVGs. The good tolerance of temporary occlusions without angiographic or clinical evidence of distal embolization represents encouraging early findings.
AB - Background - Repeat coronary artery bypass graft surgery (CABG) is associated with a high morbidity and mortality, rendering percutaneous treatment of saphenous vein graft (SVG) lesions an attractive alternative. However, percutaneous interventions of degenerated SVGs carries high risk of distal embolization. Methods and Results - This study reports our initial experience with the PercuSurge GuardWire, a new device developed to prevent embolization during treatment of degenerated SVG. This device consists of a 190-cm-long, hollow 0.014-in guidewire with a central lumen connected to a distal occlusion balloon. A dedicated inflation device (the MicroSeal Adapter) was used to inflate the distal balloon and maintain complete lumen occlusion during balloon dilatation and stent implantation. A monorail aspiration catheter, connected to a vacuum syringe, was used to evacuate atherosclerotic and thrombotic debris. Angioplasty with stent implantation was performed in 15 degenerated SVGs (18 lesions). Procedural success was achieved in all patients with normal postprocedure flow (Thrombolysis in Myocardial Infarction grade 3). No distal embolization was observed. There were no major in-hospital adverse clinical events, including Q-wave or non- Q-wave myocardial infarction, emergency CABG, or death. All patients were asymptomatic at discharge. Conclusions - This preliminary series supports the feasible use of the PercuSurge GuardWire for retrieval of plaque debris and prevention of embolization in degenerated SVGs. The good tolerance of temporary occlusions without angiographic or clinical evidence of distal embolization represents encouraging early findings.
KW - Angioplasty
KW - Embolism
KW - Grafting
KW - Veins
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M3 - Article
C2 - 10385493
AN - SCOPUS:0033614805
VL - 99
SP - 3221
EP - 3223
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 25
ER -