title: Manual aspiration prior to stenting does not reduce the incidence of filter no reflow in saphenous vein graft lesions protected by FilterWire EX/EZ.
abstract: BACKGROUND
  The beneficial role of manual thrombus aspiration in thrombus-containing lesions has been proven in acute myocardial infarction but data is lacking in saphenous vein graft lesions.
  
  
  METHODS
  From January 2004 to December 2008, 74 consecutive post-bypass patients underwent percutaneous coronary interventions to 76 saphenous vein graft lesions under the protection of FilterWire EX/EZ. Among them, the latest 25 consecutive patients with 25 lesions were treated with manual aspiration before stenting. The incidence of filter no reflow was compared between patients with and without manual aspiration pretreatment.
  
  
  RESULTS
  No major difference in demography, clinical, lesion, and procedure characteristics, and in-hospital outcome has been observed between the two patient groups. Most importantly, the incidence of filter no reflow has not been reduced (32.0% versus 19.6%, P = 0.26) by manual aspiration, even among thrombus-containing lesions (63.2% versus 64.7%, P = 1.00). The absence of diabetes mellitus is found to be the independent predictor for the occurrence of filter no reflow.
  
  
  CONCLUSIONS
  Adjunctive manual thrombus aspiration fails to reduce the filter no reflow, and probably has no additional benefit in saphenous vein graft lesions already protected by FilterWire EX/EZ.
authors.affiliation: Cardiac Medical Unit, Grantham Hospital, Hong Kong. jimmanh2002@yahoo.com
authors.forename: Man-Hong
authors.initials: MH
authors.lastname: Jim
authors.forename: Kai-Hang
authors.initials: KH
authors.lastname: Yiu
authors.forename: Ryan Lap-Yan
authors.initials: RL
authors.lastname: Ko
authors.forename: Hee-Hwa
authors.initials: HH
authors.lastname: Ho
authors.forename: Chung-Wah
authors.initials: CW
authors.lastname: Siu
authors.forename: Wing-Hing
authors.initials: WH
authors.lastname: Chow
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000009:adverse effects; D005260:Female; D018463:Filtering Surgery; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D054318:No-Reflow Phenomenon / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D011859:Radiography; D012307:Risk Factors; D012501:Saphenous Vein / Q000601:surgery / Q000637:transplantation; D015607:Stents; D017131:Thrombectomy / Q000295:instrumentation* / Q000379:methods*; D013923:Thromboembolism / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome