Dudek Dariusz, Dziewierz Artur, Kleczyński Paweł, Giszterowicz Dawid, Rakowski Tomasz, Sorysz Danuta, Rzeszutko Łukasz, Legutko Jacek, Bartuś Stanisław, Dragan Jacek, Klecha Artur, Siudak Zbigniew, Żmudka Krzysztof
Department of Interventional Cardiology, Jagiellonian University Medical College, Krakow, Poland.
Kardiol Pol. 2014;72(2):140-5. doi: 10.5603/KP.a2013.0252. Epub 2013 Oct 21.
The MGuard stent (a bare-metal stent wrapped externally in a polymer mesh sleeve) was introduced to reduce the risk of distal embolisation and no-reflow phenomenon during percutaneous coronary intervention (PCI) in thrombus containing lesions, including ST-segment elevation myocardial infarction (STEMI). However, data on the long-term performance of the MGuard stent is limited.
To assess the long-term safety and efficacy of MGuard stent implantation during primary PCI for STEMI.
In this multicentre study, a total of 60 patients with STEMI ≤12 h treated with the MGuard stent were enrolled. Angiographic success of PCI was achieved in 96.7%, with the final TIMI grade 3 flow in 90.0% of patients. At six months, the overall rate of major adverse cardiac and cerebrovascular events (MACCE; composite of cardiac death, nonfatal target vessel reinfarction, target lesion revascularisation, and stroke) was 1.7%. A long-term follow-up of the study was successfully performed in 57 patients (mean follow-up of 38.7 ± 3.1 months). The long-term cardiac mortality was 7.0%, with a MACCE rate of 8.8%. There was no decrease in the left ventricular ejection fraction and no enlargement of the left ventriclebetween index and long-term follow-up echocardiogram.
The early safety and efficacy of the MGuard stent was maintained during the long-term follow-up. However, comparative data from ongoing randomised clinical trials are still required to confirm the long-term efficacy of MGuard stent implantation in patients with STEMI.
MGuard支架(一种外部包裹聚合物网套的裸金属支架)被用于降低在经皮冠状动脉介入治疗(PCI)含血栓病变(包括ST段抬高型心肌梗死(STEMI))时远端栓塞和无复流现象的风险。然而,关于MGuard支架长期性能的数据有限。
评估MGuard支架植入术在STEMI患者直接PCI中的长期安全性和有效性。
在这项多中心研究中,共纳入60例STEMI症状出现≤12小时且接受MGuard支架治疗的患者。PCI的血管造影成功率为96.7%,90.0%的患者最终达到TIMI 3级血流。在6个月时,主要不良心脑血管事件(MACCE;包括心源性死亡、非致死性靶血管再梗死、靶病变血运重建和卒中)的总发生率为1.7%。对57例患者进行了成功的长期随访(平均随访38.7±3.1个月)。长期心源性死亡率为7.0%,MACCE发生率为8.8%。在首次和长期随访超声心动图之间,左心室射血分数没有下降,左心室也没有扩大。
在长期随访中,MGuard支架的早期安全性和有效性得以维持。然而,仍需要正在进行的随机临床试验的比较数据来证实MGuard支架植入术在STEMI患者中的长期疗效。