Morís Cesar, Lozano Iñigo, Martín María, Rondán Juán, Avanzas Pablo
Area del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain.
EuroIntervention. 2009 May;5 Suppl D:D45-50.
Saphenous veins remain a source of conduit for use in surgical coronary bypass graft revascularisation procedures. Saphenous vein grafts have a progressive closure rate estimated to be 12% to 20% at the end of the first year, and approximately 50% by 10 years. Regarding secondary revascularisation in these cases, reoperation carries substantially increased morbidity and mortality rates, making saphenous coronary intervention, in particular stent implantation, a more attractive means of revascularisation. However, this procedure carries a significant risk of major adverse clinical events, predominantly myocardial infarction or reduced antegrade flow (non-reflow phenomenon), mainly due to distal embolisation of atherothrombotic debris and distal microvascular occlusion. Embolic protection devices are used to reduce the risk of distal embolisation. There are two different designs: filter and occlusion-aspiration devices. In this article we present the different systems of embolic protection devices in saphenous percutaneous intervention and the previously published information is reviewed.
大隐静脉仍然是用于外科冠状动脉搭桥血管重建手术的移植物来源。大隐静脉移植物的闭塞率在第一年年底估计为12%至20%，到10年时约为50%。对于这些病例的二次血管重建，再次手术会使发病率和死亡率大幅增加，这使得大隐静脉冠状动脉介入治疗，特别是支架植入，成为一种更具吸引力的血管重建手段。然而，该手术存在重大不良临床事件的显著风险，主要是心肌梗死或前向血流减少（无复流现象），主要原因是动脉粥样硬化血栓碎片的远端栓塞和远端微血管闭塞。栓塞保护装置用于降低远端栓塞的风险。有两种不同的设计：滤网式和闭塞-抽吸式装置。在本文中，我们介绍了大隐静脉经皮介入治疗中栓塞保护装置的不同系统，并对先前发表的信息进行了综述。
