Safety and efficacy of a new filter-based protection system for aorto-coronary bypass graft interventions: the ev3 Spider device.
OBJECTIVE
Treatment of aorto-coronary bypass grafts without a protection devices is associated with a high incidence of ischemic events. The Spider(R) system is a new protection device.


RESULTS
We included 40 consecutive patients with 50 lesions and stenosis > 50% in bypass grafts. Follow-up was performed according to clinical records and by phone call after 30 days. Final TIMI flow 2 or 3 was observed in 97.5% of the patients, and no-reflow occurred in 10% without incidence of macroembolism. The technical success rate was 92.5%. A new rise of creatine kinase or troponin was observed in 27.5% after treatment, but 8 of 11 patients (72.7%) had only a periprocedural rise of troponin without elevation of creatine kinase. Debris was found in 52.5%, MACE rate was low (10%). Both types of stenoses (types A and B) were embolic, we found a trend for more frequent entrapped debris and periprocedural elevation of ischemic markers in type B stenoses, but these did not reach a significant level.


CONCLUSIONS
Using the Spider system is feasible, and offers a high technical success rate, no macroembolism, and excellent final TIMI flow, but the risk of microembolism and periprocedural myocardial infarction is not entirely eliminated.
Klinik fur Kardiologie, Robert-Koch-Allee 9, Bad Berka, Germany, 99437. h.korn.kar@zentralklinik-bad-berka.de
Hubertus
H
von Korn
Jiangtao
J
Yu
Burckhard
B
Huegl
Andreas
A
Wagner
Marc
M
Ohlow
Bernward
B
Lauer
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation; D001011:Aorta / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000295:instrumentation*; D023903:Coronary Restenosis / Q000517:prevention & control / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D004617:Embolism / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006440:Hemofiltration / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome