Follow up of the patients treated with the mguard stent system in percutaneous coronary intervention at afic - NIHD

ABSTRACT

The objective of this study was to conduct a follow up of the patients treated with the MGuard Stent used in Percutaneous Coronary Intervention [PCI] in the setting of acute coronary syndromes at AFIC - NIHD. The consequences of distal embolisation during PCI in acute coronary syndrome can vary from a simple sluggish flow to myocardial infarction and death. A number of protection devices reduce distal embolisation, but they add complexity and cost to the procedure. The MGuard stent is a unique innovation to counter the phenomenon. The objective of this study was to conduct an angiographic follow up of the patients treated with the MGuard Stent used in Percutaneous Coronary Intervention [PCI] in the setting of acute coronary syndromes at AFIC - NIHD. The study was conducted in AFIC - NIHD. Between April 2010 to date 21 patients were treated with a total of 25 MGuard stents. Inclusion criteria included de novo lesions in saphenous vein grafts or native vessels with angiographic evidence of thrombus activity or lesion instability and a potential for distal embolization, all in the setting of acute coronary syndromes. All patients were male. Mean age was 46.23 years [range 32-70 years]. All patients were admitted with acute coronary syndromes. Most lesions had complex morphological features and all had some thrombus activity. The MGuard stent was deployed successfully in all cases and without any complications. Secondary endpoints [TIMI - III flow and myocardial blush grade 3] were met in all cases. There was no elevation of cardiac enzymes post procedure in any patient.On follow up Nine patients [42%] had critical ISR [2 of these were total occlusions] and all required repeat intervention.One patient died within 30 days of PCI. These preliminary results show that the MGuard stent is a safe option for patients undergoing PCI in de novo coronary artery lesions in the setting of acute coronary syndrome with thrombus burden and saphenous vein graft stenosis. However the long term follow up of these patients shows significant ISR which needs to be clarified with a larger sample size