title: MGuard mesh-covered stent for treatment of ST-segment elevation myocardial infarction with high thrombus burden despite manual aspiration.
abstract: OBJECTIVE
  To assess the usefulness of the MGuard stent in patients with ST-segment elevation myocardial infarction (STEMI) in whom a high thrombus burden persists after manual aspiration.
  
  
  BACKGROUND
  In some patients with STEMI, a high thrombus burden may persist after manual aspiration. These patients may be at high risk of distal embolization and therefore impaired myocardial reperfusion. The MGuard is a novel mesh-covered stent designed to minimize thrombus embolization.
  
  
  METHODS
  Single-arm, prospective registry of patients with STEMI and high thrombus burden after aggressive thrombus aspiration treated with the MGuard stent. High thrombus burden was defined as thrombus burden grade 4 or 5 according to the TIMI score. Lesions with a side branch ≥2 mm and patients with cardiogenic shock were not included. The study end-points were proportion of final TIMI 3 flow, normal myocardial blush, and complete ST-segment resolution.
  
  
  RESULTS
  Fifty-six patients were included. After MGuard stent implantation >85% of cases had thrombus score = 0. Final TIMI 3 flow was achieved in 82% of cases, normal myocardial blush in 55%, and complete ST-segment resolution in 59%. Occlusion of a side branch (<2 mm) occurred in 2 cases (3.5%), embolization to a distal branch in 5 cases (8.9%), and transient no-reflow in 4 cases (7.1%). Major adverse cardiac events rate at 9 months was 3.6%, including 1 definite acute stent thrombosis and 1 target-vessel revascularization.
  
  
  CONCLUSIONS
  The MGuard stent may be useful to prevent distal embolization in patients with STEMI and high thrombus burden despite mechanical aspiration.
authors: Heart Diseases Institute, Bellvitge University Hospital-IDIBELL, University of Barcelona, Barcelona, Spain. rafaromaguera@gmail.com
authors: Rafael
authors: R
authors: Romaguera
authors: Joan A
authors: JA
authors: Gómez-Hospital
authors: Guillermo
authors: G
authors: Sánchez-Elvira
authors: Josep
authors: J
authors: Gómez-Lara
authors: José L
authors: JL
authors: Ferreiro
authors: Gerard
authors: G
authors: Roura
authors: Montserrat
authors: M
authors: Gracida
authors: Silvia
authors: S
authors: Homs
authors: Luis
authors: L
authors: Teruel
authors: Angel
authors: A
authors: Cequier
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D003326:Coronary Circulation; D057505:Embolic Protection Devices; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D011446:Prospective Studies; D012042:Registries; D015607:Stents; D017131:Thrombectomy