Export aspiration catheter-enhanced FilterWire delivery: an innovative strategy for treatment of saphenous vein graft disease.
We report a series of 4 cases of percutaneous saphenous vein graft intervention on thrombus-containing occlusive lesions. After passing a 0.014-inch flexible coronary wire, primary thrombosuction was performed using an Export aspiration catheter (EAC). After removing the premounted delivery sheath, a 300-cm long FilterWire EZ was loaded into the aspiration lumen of the EAC. The EAC-FilterWire assembly was then advanced across the lesion. The filter sac was deployed after withdrawing the EAC. The coronary wire was removed, and angioplasty and stenting were performed in the usual manner over the FilterWire. Filter no-reflow developed in 2 cases, which was promptly reversed by repeated manual thrombosuction using the EAC. Finally, normal coronary blood flow was restored after filter retrieval. Visible thrombi or debris were detectable in 2 patients. This interventional strategy increases the efficiency of FilterWire delivery and also gives both active and passive embolic protection without causing any adverse clinical events. It may play a positive role in saphenous vein graft intervention and primary angioplasty in the future.
Jim
Man-Hong
MH
Queen Mary Hospital, Department of Medicine, Pokfulam Road, Hong Kong. jimmanh2002@yahoo.com
Ho
Hee-Hwa
HH
Chow
Wing-Hing
WH
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods; D002404:Catheterization; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D004869:Equipment Safety; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy; D011379:Prognosis; D012501:Saphenous Vein / Q000503:physiopathology / Q000637:transplantation*; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome