Effect of distal protection device on the microvascular integrity in acute myocardial infarction during primary percutaneous coronary intervention.
BACKGROUND
The use of a distal protection device during primary percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) may preserve the microvascular integrity of the myocardium.


RESULTS
A total of 58 consecutive patients with AMI, who had undergone primary PCI within 24 h after onset, were enrolled (30 patients with the PercuSurge GuardWire System, 28 without). The coronary flow velocity reserve was not different between the 2 groups. In patients with a distal protection device, the post-PCI Thrombolysis In Myocardial Infarction myocardial perfusion grades (TMP) were more favorable (TMP 0/1: 13.3%, TMP 2: 23.3%, TMP 3: 63.4% vs TMP 0/1: 35.7%, TMP 2: 35.7%, TMP 3: 28.6%, p=0.023). These patients also exhibited lower basal and hyperemic microvascular resistance index levels (4.33+/-2.22 vs 5.55+/-2.36 mmHg . cm(-1) . s, p=0.047; 2.39+/-1.40 vs 3.14+/-1.36 mmHg . cm(-1) . s, p=0.045, respectively), and longer basal diastolic deceleration time (679+/-273 vs 519+/-289 ms, p=0.035) after PCI.


CONCLUSIONS
Distal protection with the PercuSurge GuardWire system may effectively preserve the microvascular integrity of the myocardium during primary PCI in AMI patients.
Yoon
Myeong-Ho
MH
Department of Cardiology, Ajou University School of Medicine, Suwon, Korea.
Tahk
Seung-Jea
SJ
Choi
So-Yeon
SY
Choi
Tae-Young
TY
Choi
Byoung-Joo
BJ
Choi
Jung-Hyun
JH
Yoo
Sang-Yong
SY
Ahn
Sung-Gyun
SG
Zheng
Zhen-Guo
ZG
Hwang
Gyo-Seung
GS
Shin
Joon-Han
JH
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D001783:Blood Flow Velocity; D003331:Coronary Vessels / Q000503:physiopathology*; D004864:Equipment and Supplies / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000503:physiopathology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*