Prevention of distal embolization during saphenous vein graft lesion angioplasty: Experience with a new temporary occlusion and aspiration system

Mauro Carlino, Joseph De Gregorio, Carlo Di Mario, Angelo Anzuini, Flavio Airoldi, Remo Albiero, Carlo Briguori, Aniruddha Dharmadhikari, Imad Sheiban, Antonio Colombo

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)3221-3223
Number of pages3
JournalCirculation
Volume99
Issue number25
Publication statusPublished - Jun 29 1999

Keywords

  • Angioplasty
  • Embolism
  • Grafting
  • Veins

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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    Carlino, M., De Gregorio, J., Di Mario, C., Anzuini, A., Airoldi, F., Albiero, R., Briguori, C., Dharmadhikari, A., Sheiban, I., & Colombo, A. (1999). Prevention of distal embolization during saphenous vein graft lesion angioplasty: Experience with a new temporary occlusion and aspiration system. Circulation, 99(25), 3221-3223.