title: [MGuard Dacron mesh-covered stent implantation in patients with ST-elevation myocardial infarction and high thrombotic burden: in-hospital and long-term outcome in a single high-volume center].
abstract: BACKGROUND
  The MGuard (MG) is a stainless-steel closed cell stent covered with an ultra-thin polymer mesh sleeve, which has the purpose of ensuring reduced distal embolization of thrombotic material, thus lowering the risk of no-reflow/slow-flow phenomena. Only few data are available that evaluated the usefulness of the MG stent in patients with ST-elevation myocardial infarction (STEMI) with a high thrombotic burden.
  
  
  METHODS
  We prospectively collected data of patients presenting with STEMI and high thrombotic burden (thrombus burden grade 4 or 5 according to the TIMI score) who underwent primary percutaneous coronary intervention (PCI) with MG stent implantation in our center. Lesions involving a bifurcation or very calcified and tortuous vessels were not included. Final TIMI 3 flow, normal myocardial blush grade (MBG), and complete ST-segment resolution were defined as short-term endpoints, whereas major adverse cardiovascular events were evaluated during follow-up.
  
  
  RESULTS
  From August 2008 to June 2013, the MG stent was implanted in 104 (9.3%) of 1108 patients who underwent primary PCI. Cardiogenic shock on admission was present in 4 patients (3.8%). Final TIMI 3 flow was achieved in 97.1% of patients, MBG 3 in 56.7%, and regression of ST-segment elevation ≥70% within 90 min was recorded in 64.4% of patients. In-hospital mortality was 2.9% (n=3), and at a mean follow-up of 455±430 days overall major adverse cardiovascular events were 11 (10.6%). Cardiac death occurred in 5 patients (4.9%) and stent thrombosis in 2 (1.9%).
  
  
  CONCLUSIONS
  In selected patients with STEMI undergoing primary PCI, the use of the mesh-covered MG stent in vessels with high thrombotic burden despite thrombus aspiration was effective and safe both immediately and at mid-term follow-up.
authors.affiliation: Cardiologia, Ospedali degli Infermi, Rivoli (TO).
authors.forename: Enrico
authors.initials: E
authors.lastname: Cerrato
authors.affiliation: Cardiologia, Ospedali degli Infermi, Rivoli (TO).
authors.forename: Cristina
authors.initials: C
authors.lastname: Rolfo
authors.affiliation: Cardiologia, Ospedali degli Infermi, Rivoli (TO).
authors.forename: Francesco
authors.initials: F
authors.lastname: Tomassini
authors.affiliation: Cardiologia, Ospedali degli Infermi, Rivoli (TO).
authors.forename: Nicolò
authors.initials: N
authors.lastname: Montali
authors.affiliation: Cardiologia, Ospedali degli Infermi, Rivoli (TO).
authors.forename: Alfonso
authors.initials: A
authors.lastname: Gambino
authors.affiliation: Cardiologia, Ospedali degli Infermi, Rivoli (TO).
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Infantino
authors.affiliation: Cardiologia, Ospedali degli Infermi, Rivoli (TO).
authors.forename: Sara
authors.initials: S
authors.lastname: Palacio Restrepo
authors.affiliation: Cardiologia, Ospedali degli Infermi, Rivoli (TO).
authors.forename: Denise
authors.initials: D
authors.lastname: Baricocchi
authors.affiliation: Cardiologia, Ospedali degli Infermi, Rivoli (TO).
authors.forename: Rosa
authors.initials: R
authors.lastname: Nevola
authors.affiliation: Cardiologia, Ospedali degli Infermi, Rivoli (TO).
authors.forename: Andrea
authors.initials: A
authors.lastname: Gagnor
authors.affiliation: Cardiologia, Ospedali degli Infermi, Rivoli (TO).
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Varbella
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003326:Coronary Circulation; D003328:Coronary Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D012720:Severity of Illness Index; D015607:Stents / Q000009:adverse effects; D013499:Surface Properties; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D011093:Polyethylene Terephthalates