Vaknin-Assa Hana, Assali Abid, Lev Eli I, Greenberg Gabriel, Orvin Katia, Valzer Orna, Paul Gideon, Levi Amos, Kornowski Ran
Department of Cardiology, Rabin Medical Center (Beilinson Campus), Petah Tikva, affiliated with Sacker Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr Med Assoc J. 2017 Mar;19(3):172-176.
The MGuard™ stent (InspireMD, Tel Aviv, Israel) is a bare metal mesh-covered stent, developed to prevent no-reflow phenomenon during percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) and acute myocardial infarction (MI), both associated with significant atherothrombotic lesions.
To report on local experience with patients treated with the MGuard stent until follow-up at 1 year.
We followed 163 consecutive patients who underwent MGuard stent deployment during the period 2009 to 2014 in a large tertiary cardiac center in central Israel.
The MGuard stent was used in 67% of patients who underwent SVG-PCI while 33% were treated for native coronary artery disease, the majority during ST-elevation MI (STEMI). The mean age was 67 years and 83% were males. The clinical presentation was STEMI in 30% and non-STEMI/unstable angina in 60% of patients. Of the total number of patients, 47% had diabetes and 29% had chronic kidney disease. All patients had follow-up at 1 year. Mortality in the native group was 1.9% vs. 10% in the vein graft cohort. ST was 2% in both groups. The major adverse cardiac event (MACE) rates were 11% in the native artery and 29% in the vein graft group, mainly due to respective target lesion revascularization/target vessel revascularization rates of 6% and 7% in the native vessel group and 11% and 15% in the SVG group.
In suitable patients undergoing SVG-PCI or native lesion intervention during acute MI, the MGuard stent is a viable treatment strategy. Its potential merits and limitations warrant further evaluation.
MGuard™支架（InspireMD公司，以色列特拉维夫）是一种裸金属网覆盖支架，旨在预防在隐静脉桥（SVG）经皮冠状动脉介入治疗（PCI）和急性心肌梗死（MI）期间的无复流现象，这两种情况均与严重的动脉粥样硬化血栓形成病变相关。
报告使用MGuard支架治疗的患者至1年随访时的当地经验。
我们对2009年至2014年期间在以色列中部一家大型三级心脏中心接受MGuard支架置入的163例连续患者进行了随访。
67%接受SVG-PCI的患者使用了MGuard支架，33%用于治疗原发性冠状动脉疾病，大多数患者在ST段抬高型心肌梗死（STEMI）期间使用。平均年龄为67岁，83%为男性。30%的患者临床表现为STEMI，60%为非STEMI/不稳定型心绞痛。在所有患者中，47%患有糖尿病，29%患有慢性肾脏病。所有患者均进行了1年随访。原发性组的死亡率为1.9%，而静脉桥组为10%。两组的支架血栓形成率均为2%。主要不良心脏事件（MACE）发生率在原发性动脉组为11%，在静脉桥组为29%，主要是由于原发性血管组的靶病变血运重建/靶血管血运重建率分别为6%和7%，SVG组为11%和15%。
对于在急性心肌梗死期间接受SVG-PCI或原发性病变干预的合适患者，MGuard支架是一种可行的治疗策略。其潜在的优点和局限性值得进一步评估。
