Distal Protection During Primary Angioplasty in Patients with Acute
Myocardial Infarction
Červinka P., Špaček R., Bystroň M., Kvašňák M., Běhounek M., BednářováJ., Herman J., 1Veselka J.
Kardiologické oddělení – Masarykova nemocnice, Ústí nad Labem 1Kardiologické oddělení FNM, Praha |
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Summary:
Background. The aim of the study was to assess the safety, feasibility and efficacy of mechanical distal protection
during primary angioplasty using FilterWire EZ® (FW).
Method and Results. Thirty-one patients with acute myocardial infarction (AMI) were treated by primary angioplasty
with distal protection using FW. The results were compared with a matched control group consisting of 33 patients
with AMI treated by primary angioplasty alone. Successful FW positioning was obtained in 30 patients (97 %).
In these patients a lower rate of distal embolisation (3 vs. 18%, p=0,04) was found and a more effective reperfusion
was assessed by ST elevation’s resolution >50% immediately after the procedure (83 vs.61 %, p=0,05). A higher number
of patients with corrected TIMI frame count <27 in FW group supported more effective reperfusion to but this
difference did not reached statistical significance (87 vs. 73 %, p=0,09). There were no differences between groups
regarding average peak CK and CK-MB. However, there is a trend to lower release in FW group (32,1±24,5 vs.
35,3±31,0, p= 0,33; 4,2±3 vs. 4,4±3,7, p=0,44).
Conclusions. The presented study confirmed that distal embolisation during primary angioplasty is a frequent phenomenon.
In this setting, adjunctive use of the FW is feasible and save, and it may improve myocardial reperfusion
by reducing the embolic events.
Key words:
acute myocardial infarction, primary angioplasty, embolism, distal protection.
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