Manual aspiration prior to stenting does not reduce the incidence of filter no reflow in saphenous vein graft lesions protected by FilterWire EX/EZ.
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.
Jim
Man-Hong
MH
Cardiac Medical Unit, Grantham Hospital, Hong Kong. jimmanh2002@yahoo.com
Yiu
Kai-Hang
KH
Ko
Ryan Lap-Yan
RL
Ho
Hee-Hwa
HH
Siu
Chung-Wah
CW
Chow
Wing-Hing
WH
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