A randomized, controlled trial of saphenous vein graft intervention with a filter-based distal embolic protection device: TRAP trial.
The purpose of this prospective, multicenter trial was to evaluate the safety and effectiveness of the TRAP Vascular Filtration System (VFS) to reduce embolic complications during stenting of diseased saphenous vein grafts (SVGs). Patients with SVG lesions were randomly assigned to undergo stenting with or without the TRAP device. The trial was designed to enroll 752 randomized patients. However, the sponsor terminated the study after a total of 467 patients (358 randomized) were enrolled because of poor recruitment once another distal protection device was approved for clinical use. The primary study endpoint, major adverse cardiac events at 30 days, occurred in 17.3% of control patients and 12.7% of patients treated with the TRAP device (P = 0.24). There was a trend toward a lower incidence of myocardial infarction in the TRAP group compared with the control group (16.2% vs 10.5%, P = 0.12). This difference was predominantly due to a lower incidence of moderate-large infarction (CKMB >5x) in the TRAP group. Use of the TRAP VFS during SVG intervention was safe and was associated with a trend toward a lower incidence of adverse events, however, due to low enrollment the study lacked sufficient power to detect a significant benefit with the device.
Dixon
Simon R
SR
William Beaumont Hospital, Royal Oak, MI 48073, USA. sdixon@beaumont.edu
Mann
J Tift
JT
Lauer
Michael A
MA
Casale
Paul N
PN
Dippel
Eric J
EJ
Strumpf
Robert K
RK
Feldman
Robert L
RL
Shear
Wendy
W
Resar
Jon R
JR
Zimmer
Stevan D
SD
O'Neill
William W
WW
D000368:Aged; D002404:Catheterization / Q000295:instrumentation*; D004617:Embolism / Q000517:prevention & control*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000628:therapy*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D015607:Stents