title: The use of a novel type of distal protection system (FiberNet®) in the percutaneous management of saphenous vein graft disease.
abstract: Percutaneous intervention in saphenous vein grafts is associated with a high risk of distal embolisation by plaque material, 'no flow' phenomenon and clinical complications such as myocardial infarction or death. According to randomised trial evidence, intervention in a degenerated vein graft should be performed using an embolic protection device (EPD), since this strategy significantly reduces periprocedural and 30 day adverse event rate. FiberNet® is a novel distal protection system with unique characteristics of a low crossing profile (0.031'' for vessel size 3.5-5 mm), 'cotton wool'-like three dimensional design and a small pore size (40 μm). The FiberNet® does not require a separate delivery sheath and self-achieves its optimal apposition to the vessel wall; the EPD system also contains a dedicated aspiration catheter. We present the use of FiberNet® in a 77 year-old patient who had undergone coronary artery bypass grafting 20 years ago and currently presented with CCS class III angina due to a significant stenosis of the saphenous vein graft to the marginal branch. The procedure involved the use of a novel mesh-covered stent (MGuard®) designed to 'trap' the plaque material between the stent and the vessel wall. It was technically successful and clinically uncomplicated, and the patient remains well six months later.
authors.affiliation: Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Collegium Medicum, The John Paul II Hospital, Krakow, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Pieniążek
authors.forename: Karolina
authors.initials: K
authors.lastname: Dzierwa
authors.forename: Piotr
authors.initials: P
authors.lastname: Musiałek
authors.forename: Marta
authors.initials: M
authors.lastname: Hlawaty
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Tekieli
authors.forename: Piotr
authors.initials: P
authors.lastname: Paluszek
authors.forename: Bartosz
authors.initials: B
authors.lastname: Laskowicz
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Zmudka
authors.forename: Piotr
authors.initials: P
authors.lastname: Podolec
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery*; D057505:Embolic Protection Devices; D006801:Humans; D008297:Male; D012501:Saphenous Vein / Q000637:transplantation*; D015607:Stents