Abstract
To assess the usefulness of the MGuard stent in patients with ST-segment elevation myocardial infarction (STEMI) in whom a high thrombus burden persists after manual aspiration. In some patients with STEMI, a high thrombus burden may persist after manual aspiration. These patients may be at high risk of distal embolization and therefore impaired myocardial reperfusion. The MGuard is a novel mesh-covered stent designed to minimize thrombus embolization. Single-arm, prospective registry of patients with STEMI and high thrombus burden after aggressive thrombus aspiration treated with the MGuard stent. High thrombus burden was defined as thrombus burden grade 4 or 5 according to the TIMI score. Lesions with a side branch ≥2 mm and patients with cardiogenic shock were not included. The study end-points were proportion of final TIMI 3 flow, normal myocardial blush, and complete ST-segment resolution. Fifty-six patients were included. After MGuard stent implantation >85% of cases had thrombus score = 0. Final TIMI 3 flow was achieved in 82% of cases, normal myocardial blush in 55%, and complete ST-segment resolution in 59%. Occlusion of a side branch (<2 mm) occurred in 2 cases (3.5%), embolization to a distal branch in 5 cases (8.9%), and transient no-reflow in 4 cases (7.1%). Major adverse cardiac events rate at 9 months was 3.6%, including 1 definite acute stent thrombosis and 1 target-vessel revascularization. The MGuard stent may be useful to prevent distal embolization in patients with STEMI and high thrombus burden despite mechanical aspiration.
Highlights
In patients with ST‐segment elevation myocardial infarction (STEMI), distal embolization during percutaneous coronary intervention (PCI) is a common complication that may cause impaired myocardial reperfusion even with a patent epicardial vessel.[1,2] The MGuardTM stent (InspireMD, Tel Aviv, Israel) is a novel mesh‐covered stent that has been designed to Address for reprints: Rafael Romaguera, M.D., Hospital Universitari de Bellvitge, Feixa llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
Were: (1) myocardial infarction with persistent chest pain and ST‐ segment elevation of !2 mm in 2 or more contiguous electrocardiographic leads; (2) evidence on coronary angiogram of high thrombus burden after aggressive mechanical aspiration, defined as thrombus grade 4–5 according to the TIMI score[4]; and (3) vessel diameter !2.5 and 4 mm by visual estimation
In 3 instances (5.4%), the procedure was performed after failed thrombolysis
Summary
The MGuard stent has been shown to be safe and effective in consecutive patients with STEMI, its use in selected patients with persistent high thrombus burden after thrombus aspiration has not been described
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
