Jim Man-Hong, Yiu Kai-Hang, Ko Ryan Lap-Yan, Ho Hee-Hwa, Siu Chung-Wah, Chow Wing-Hing
Cardiac Medical Unit, Grantham Hospital, Hong Kong.
Acute Card Care. 2010 Sep;12(3):92-5. doi: 10.3109/17482941.2010.490194.
The beneficial role of manual thrombus aspiration in thrombus-containing lesions has been proven in acute myocardial infarction but data is lacking in saphenous vein graft lesions.
From January 2004 to December 2008, 74 consecutive post-bypass patients underwent percutaneous coronary interventions to 76 saphenous vein graft lesions under the protection of FilterWire EX/EZ. Among them, the latest 25 consecutive patients with 25 lesions were treated with manual aspiration before stenting. The incidence of filter no reflow was compared between patients with and without manual aspiration pretreatment.
No major difference in demography, clinical, lesion, and procedure characteristics, and in-hospital outcome has been observed between the two patient groups. Most importantly, the incidence of filter no reflow has not been reduced (32.0% versus 19.6%, P = 0.26) by manual aspiration, even among thrombus-containing lesions (63.2% versus 64.7%, P = 1.00). The absence of diabetes mellitus is found to be the independent predictor for the occurrence of filter no reflow.
Adjunctive manual thrombus aspiration fails to reduce the filter no reflow, and probably has no additional benefit in saphenous vein graft lesions already protected by FilterWire EX/EZ.
