Embolic protection devices in saphenous percutaneous intervention.
Saphenous veins remain a source of conduit for use in surgical coronary bypass graft revascularisation procedures. Saphenous vein grafts have a progressive closure rate estimated to be 12% to 20% at the end of the first year, and approximately 50% by 10 years. Regarding secondary revascularisation in these cases, reoperation carries substantially increased morbidity and mortality rates, making saphenous coronary intervention, in particular stent implantation, a more attractive means of revascularisation. However, this procedure carries a significant risk of major adverse clinical events, predominantly myocardial infarction or reduced antegrade flow (non-reflow phenomenon), mainly due to distal embolisation of atherothrombotic debris and distal microvascular occlusion. Embolic protection devices are used to reduce the risk of distal embolisation. There are two different designs: filter and occlusion-aspiration devices. In this article we present the different systems of embolic protection devices in saphenous percutaneous intervention and the previously published information is reviewed.
Morís
Cesar
C
Area del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain. cesarmoris@gmail.com
Lozano
Iñigo
I
Martín
María
M
Rondán
Juán
J
Avanzas
Pablo
P
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation; D021721:Balloon Occlusion / Q000295:instrumentation*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000601:surgery*; D004617:Embolism / Q000209:etiology / Q000517:prevention & control*; D004867:Equipment Design; D005374:Filtration / Q000295:instrumentation*; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000628:therapy*; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control; D054318:No-Reflow Phenomenon / Q000209:etiology / Q000517:prevention & control; D012501:Saphenous Vein / Q000637:transplantation*; D015607:Stents; D013396:Suction / Q000295:instrumentation*; D017211:Treatment Failure