851 Long Term Angiographic Follow-Up of Saphenous Vein Graft Interventions Using Distal Embolisation Protection Devices

Abstract

Use of distal embolisation protection devices (DEPD) for Saphenous Vein Graft (SVG) interventions is a Class I recommendation on interventional guidelines. There is limited long term angiographic follow-up on the outcomes of DEPD usage, particularly the development of de novo lesions at site of DEPD deployment. We retrospectively reviewed a database of patients at Royal North Shore Hospital who had SVG interventions between 2008 and 2019. Use of DEPD was determined. Patients with subsequent angiography were reviewed for the presence of target lesion failure, particularly at the site of DEPD deployment. A total of 506 patients had SVG interventions. Of these, 92 (18.2%) cases were performed using a DEPD (78 Filter Wire, 14 Defender Coronary Filter). 56 patients had repeat angiography performed, with a mean follow-up period of 35.6 months. Complete graft occlusion was noted in 6 patients (10.7%). Severe de novo lesions were noted at site of DEPD deployment in 4 cases (7.1%), and de novo disease in segments without prior DEPD deployment occurred in 5 cases (8.9%). SVG disease progression occurred frequently, including de novo disease at the site of DEPD deployment. This possibly a consequence of natural disease progression or device-related endothelial disturbance.