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Comparative analysis of a Distal Protection System and the new stent MGuardTM for the treatment of complex lesions in saphenous vein grafts

BACKGROUND: Percutaneous coronary intervention in saphenous vein grafts remain a major challenge due to the high complication rates associated to the procedure. The new balloon-expandable MGuardTM stent was developed with an ultra-thin mesh sleeve attached to its outer surface, designed to reduce distal embolization during the procedure. Our objective was to evaluate the efficacy of the new device to prevent periprocedural embolic complications. METHODS: A consecutive cohort of patients with complex saphenous vein graft lesions treated with the MGuardTM stent were compared to patients treated with bare metal stents and distal filter protection. The primary objective included the occurrence of major adverse cardiovascular events (composite of death, non-fatal myocardial infarction and target lesion revascularization) up to 30 days of the procedure. RESULTS: Thirty-eight patients were evaluated, 16 in the MGuardTM group and 22 patients in the distal filter protection group. Most patients were male (81.6%) and the mean age of the treated grafts was 10.4 ± 5.6 years. Distal filter protection group patients had longer lesions (17.4 ± 6.3 mm vs. 26 ± 16.2 mm; P = 0.052) and higher thrombus burden (6.3% vs. 50%; P = 0.005). There were no major adverse cardiac events in any of the groups up to 30 days of the procedure. CONCLUSIONS: The MGuardTM stent proved to be effective in the treatment of complex saphenous vein graft lesions in our series of patients. Randomized comparisons with a larger number of patients must be carried out in the future to confirm these preliminary results.

Stents; Saphenous vein; Coronary vessels; Myocardial infarction


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