VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Catheter Cardiovasc Interv. 2012 Dec 1;80(7):1120-6. doi: 10.1002/ccd.23471. Epub 2012 Mar 15.
Although embolic protection devices (EPDs) have been shown to be beneficial in saphenous vein graft (SVG) lesions, their role in the subgroup of ostial SVG lesions has received limited study.
The coronary angiograms and procedural outcomes of 109 patients undergoing stenting of 113 ostial SVG lesions were retrospectively reviewed to determine the frequency of EPD use and the periprocedural outcomes.
Ninety-eight (87%) of the 113 lesions were suitable for EPD use, that was used in 70 lesions (71%). A Filterwire (Boston Scientific) or a SPIDER (ev3) filter were used in 54 (77%) and 16 (23%) of lesions, respectively. Difficulty retrieving the filter post stenting was encountered in eight lesions (11%) and led to stent thrombosis causing cardiac arrest in one patient (1%). Angiographic success was achieved in 111 (98%) of 113 lesions.
EPDs can be utilized in the majority of ostial SVG lesions, but in 11% of cases filter retrieval can be challenging and may rarely (in approximately 1%) lead to a significant complication.
虽然栓塞保护装置 (EPD) 已被证明对隐静脉移植物 (SVG) 病变有益，但它们在 SVG 开口病变亚组中的作用研究有限。
回顾性分析了 109 例接受 113 例 SVG 开口病变支架置入术的患者的冠状动脉造影和手术结果，以确定 EPD 使用的频率和围手术期结果。
113 个病变中有 98 个（87%）适合使用 EPD，其中 70 个病变（71%）使用了 EPD。54 个病变（77%）和 16 个病变（23%）分别使用了 Filterwire（波士顿科学公司）或 SPIDER（ev3）过滤器。在 8 个病变（11%）中，在支架置入后取出过滤器遇到困难，导致支架血栓形成并导致 1 例患者心脏骤停（1%）。113 个病变中有 111 个（98%）达到了血管造影成功。
EPD 可用于大多数 SVG 开口病变，但在 11%的病例中，过滤器取出可能具有挑战性，并且在极少数情况下（约 1%）可能导致严重并发症。
