Embolic protection during saphenous vein graft intervention using a second-generation balloon protection device: results from the combined US and European pilot study of the TriActiv Balloon Protected Flush Extraction System.
BACKGROUND
Stent placement in saphenous vein bypass grafts is associated with a high incidence of myonecrosis usually resulting from embolization of thrombus and friable atheroma. Embolic protection devices reduce the incidence of adverse events after vein graft stenting. However, first-generation balloon occlusion systems are still associated with a 10% incidence of periprocedural adverse events. We report the first experience with a new second-generation balloon occlusion embolic protection device, the TriActiv Balloon Protected Flush Extraction System.


METHODS
Ninety-six lesions in 78 saphenous vein grafts were treated in 74 patients. The primary end point was major adverse cardiovascular events at 30 days.


RESULTS
Device success was achieved in 92% of patients, and atheromatous debris was recovered in 69% of analyzed aspirates. By 30 days, major adverse cardiovascular events, which were limited to non-Q-wave myocardial infarctions, occurred in 16.2%. Per protocol analysis in patients with device success revealed a rate of adverse events of only 5.7%.


CONCLUSIONS
The initial experience with the TriActiv Balloon Protected Flush Extraction System demonstrated a high success rate and recovery of embolic debris with an acceptable rate of adverse events. A large randomized trial will compare this device to other embolic protection systems.
Carrozza
Joseph P
JP
Section of Interventional Cardiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. jcarrozz@bidmc.harvard.edu
Caussin
Christophe
C
Braden
Gregory
G
Braun
Peter
P
Hansell
Forde
F
Fatzinger
Robin
R
Walters
Greg
G
Kussmaul
William
W
Breall
Jeffrey
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D050197:Atherosclerosis / Q000150:complications / Q000628:therapy*; D021721:Balloon Occlusion; D002404:Catheterization; D004617:Embolism / Q000209:etiology / Q000517:prevention & control*; D004867:Equipment Design; D005060:Europe; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012501:Saphenous Vein / Q000637:transplantation*; D014481:United States