MGuard mesh-covered stent for treatment of ST-segment elevation myocardial infarction with high thrombus burden despite manual aspiration

Objectives: 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. Background: In some patients with STEMI, a high thrombus burden may persist after manual aspiration. These pat...

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Detalles Bibliográficos
Autores: Romaguera, Rafael, Gómez Hospital, Joan Antoni, Sánchez Elvira, Guillermo, Gómez Lara, Josep, Ferreiro, José Luis, Roura i Ferrer, Gerard, Gracida Blancas, Montserrat, Homs, Silvia, Teruel, Luís M., Cequier Fillat, Àngel R.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2013
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/151121
Acceso en línea:https://hdl.handle.net/2445/151121
Access Level:acceso abierto
Palabra clave:Infart de miocardi
Pròtesis de Stent
Myocardial infarction
Stents (Surgery)
Descripción
Sumario:Objectives: 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. Background: 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. Methods: 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. Results: 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. Conclusions: The MGuard stent may be useful to prevent distal embolization in patients with STEMI and high thrombus burden despite mechanical aspiration.