Initial clinical experience with distal protection using the FilterWire in patients undergoing coronary artery and saphenous vein graft percutaneous intervention
Identifieur interne : 001A05 ( Istex/Corpus ); précédent : 001A04; suivant : 001A06Initial clinical experience with distal protection using the FilterWire in patients undergoing coronary artery and saphenous vein graft percutaneous intervention
Auteurs : Jeffrey J. Popma ; Nicholas Cox ; K. Eugene Hauptmann ; Nicolaus Reifart ; Renu Virmani ; Khaled Emira ; Sabina Murphy ; C. Michael Gibson ; Eberhard GrubeSource :
- Catheterization and Cardiovascular Interventions [ 1522-1946 ] ; 2002-10.
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Abstract
Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) and native coronary arteries may be associated with embolization of particulate debris into the distal microcirculation. The FilterWire uses a polyurethane filter bag contained on a radiopaque loop to trap embolic debris during native vessel and SVG intervention. The objectives of this study were to assess the feasibility and safety of the FilterWire during PCI and to examine the size and content of the particulate debris captured during SVG and native vessel intervention. Early angiographic, in‐hospital, and 30‐day clinical outcomes were reviewed in 35 patients with 36 lesions treated with the FilterWire during PCI. Lesions were located in 22 (61%) native coronary arteries and in 14 (39%) SVGs. Multivessel coronary artery disease was present in 75% of patients. Lesions were complex (ACC/AHA complexity B2 or C) in 81% of cases. The FilterWire was successfully delivered and deployed distal to the site of coronary intervention in 92% of lesions, including 95% of native vessels and 82% of SVG lesions. Embolic debris was entrapped in 82% of these cases. The average particulate debris had a mean major axis of 490 μm (range, 45–3,302 μm) and minor axis of 226 μm (range, 33–1,677 μm). Although reduced flow was common (36.1%) when the FilterWire was in place, there were no sustained episodes of abrupt closure and only one (2.8%) patient developed sustained no‐reflow after FilterWire removal. Distal branch vessel embolization was found in four (11.1%) cases. Major adverse cardiac events occurred in 5 (14%) of 35 patients treated with the device, although 2 of these patients were evolving an acute myocardial infarction at the time of the procedure; in patients meeting the prospectively defined inclusion criteria, the major adverse cardiac event was 6%. These results suggest that the FilterWire is a feasible and safe method of collecting particulate debris released during SVG and native vessel coronary intervention. Its benefit over conventional therapy and other distal protection devices is currently under study. Cathet Cardiovasc Intervent 2002;57:125–134. © 2002 Wiley‐Liss, Inc.
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DOI: 10.1002/ccd.10313
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Initial clinical experience with distal protection using the FilterWire in patients undergoing coronary artery and saphenous vein graft percutaneous intervention</title><author><name sortKey="Popma, Jeffrey J" sort="Popma, Jeffrey J" uniqKey="Popma J" first="Jeffrey J." last="Popma">Jeffrey J. Popma</name><affiliation><mods:affiliation>Department of Internal Medicine, Cardiovascular Divisions, Brigham and Women's Hospital, Boston, Massachusetts</mods:affiliation></affiliation><affiliation><mods:affiliation>Interventional Cardiology, Brigham and Women's Hospital, 75 Francis Street, L‐2 Catheterization Laboratory, Boston, MA 02115</mods:affiliation></affiliation></author><author><name sortKey="Cox, Nicholas" sort="Cox, Nicholas" uniqKey="Cox N" first="Nicholas" last="Cox">Nicholas Cox</name><affiliation><mods:affiliation>Department of Internal Medicine, Cardiovascular Divisions, Brigham and Women's Hospital, Boston, Massachusetts</mods:affiliation></affiliation></author><author><name sortKey="Hauptmann, K Eugene" sort="Hauptmann, K Eugene" uniqKey="Hauptmann K" first="K. Eugene" last="Hauptmann">K. Eugene Hauptmann</name><affiliation><mods:affiliation>Krankenhaus D. Barmh Bruder, Trier, Germany</mods:affiliation></affiliation></author><author><name sortKey="Reifart, Nicolaus" sort="Reifart, Nicolaus" uniqKey="Reifart N" first="Nicolaus" last="Reifart">Nicolaus Reifart</name><affiliation><mods:affiliation>Kardiologisches Institut Main‐Taunus, Taunus, Germany</mods:affiliation></affiliation></author><author><name sortKey="Virmani, Renu" sort="Virmani, Renu" uniqKey="Virmani R" first="Renu" last="Virmani">Renu Virmani</name><affiliation><mods:affiliation>Armed Forces Institute of Pathology, Washington, D.C</mods:affiliation></affiliation></author><author><name sortKey="Emira, Khaled" sort="Emira, Khaled" uniqKey="Emira K" first="Khaled" last="Emira">Khaled Emira</name><affiliation><mods:affiliation>Department of Internal Medicine, Cardiovascular Divisions, Brigham and Women's Hospital, Boston, Massachusetts</mods:affiliation></affiliation></author><author><name sortKey="Murphy, Sabina" sort="Murphy, Sabina" uniqKey="Murphy S" first="Sabina" last="Murphy">Sabina Murphy</name><affiliation><mods:affiliation>Harvard Clinical Research Institute, Boston, Massachusetts</mods:affiliation></affiliation></author><author><name sortKey="Gibson, C Michael" sort="Gibson, C Michael" uniqKey="Gibson C" first="C. Michael" last="Gibson">C. Michael Gibson</name><affiliation><mods:affiliation>Harvard Clinical Research Institute, Boston, Massachusetts</mods:affiliation></affiliation></author><author><name sortKey="Grube, Eberhard" sort="Grube, Eberhard" uniqKey="Grube E" first="Eberhard" last="Grube">Eberhard Grube</name><affiliation><mods:affiliation>Heart Center, Siegburg, Germany</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:277C98683DDCBFAB6C9EC1429C50BC9A677EBA2D</idno><date when="2002" year="2002">2002</date><idno type="doi">10.1002/ccd.10313</idno><idno type="url">https://api.istex.fr/document/277C98683DDCBFAB6C9EC1429C50BC9A677EBA2D/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001A05</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001A05</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Initial clinical experience with distal protection using the FilterWire in patients undergoing coronary artery and saphenous vein graft percutaneous intervention</title><author><name sortKey="Popma, Jeffrey J" sort="Popma, Jeffrey J" uniqKey="Popma J" first="Jeffrey J." last="Popma">Jeffrey J. Popma</name><affiliation><mods:affiliation>Department of Internal Medicine, Cardiovascular Divisions, Brigham and Women's Hospital, Boston, Massachusetts</mods:affiliation></affiliation><affiliation><mods:affiliation>Interventional Cardiology, Brigham and Women's Hospital, 75 Francis Street, L‐2 Catheterization Laboratory, Boston, MA 02115</mods:affiliation></affiliation></author><author><name sortKey="Cox, Nicholas" sort="Cox, Nicholas" uniqKey="Cox N" first="Nicholas" last="Cox">Nicholas Cox</name><affiliation><mods:affiliation>Department of Internal Medicine, Cardiovascular Divisions, Brigham and Women's Hospital, Boston, Massachusetts</mods:affiliation></affiliation></author><author><name sortKey="Hauptmann, K Eugene" sort="Hauptmann, K Eugene" uniqKey="Hauptmann K" first="K. Eugene" last="Hauptmann">K. Eugene Hauptmann</name><affiliation><mods:affiliation>Krankenhaus D. Barmh Bruder, Trier, Germany</mods:affiliation></affiliation></author><author><name sortKey="Reifart, Nicolaus" sort="Reifart, Nicolaus" uniqKey="Reifart N" first="Nicolaus" last="Reifart">Nicolaus Reifart</name><affiliation><mods:affiliation>Kardiologisches Institut Main‐Taunus, Taunus, Germany</mods:affiliation></affiliation></author><author><name sortKey="Virmani, Renu" sort="Virmani, Renu" uniqKey="Virmani R" first="Renu" last="Virmani">Renu Virmani</name><affiliation><mods:affiliation>Armed Forces Institute of Pathology, Washington, D.C</mods:affiliation></affiliation></author><author><name sortKey="Emira, Khaled" sort="Emira, Khaled" uniqKey="Emira K" first="Khaled" last="Emira">Khaled Emira</name><affiliation><mods:affiliation>Department of Internal Medicine, Cardiovascular Divisions, Brigham and Women's Hospital, Boston, Massachusetts</mods:affiliation></affiliation></author><author><name sortKey="Murphy, Sabina" sort="Murphy, Sabina" uniqKey="Murphy S" first="Sabina" last="Murphy">Sabina Murphy</name><affiliation><mods:affiliation>Harvard Clinical Research Institute, Boston, Massachusetts</mods:affiliation></affiliation></author><author><name sortKey="Gibson, C Michael" sort="Gibson, C Michael" uniqKey="Gibson C" first="C. Michael" last="Gibson">C. Michael Gibson</name><affiliation><mods:affiliation>Harvard Clinical Research Institute, Boston, Massachusetts</mods:affiliation></affiliation></author><author><name sortKey="Grube, Eberhard" sort="Grube, Eberhard" uniqKey="Grube E" first="Eberhard" last="Grube">Eberhard Grube</name><affiliation><mods:affiliation>Heart Center, Siegburg, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Catheterization and Cardiovascular Interventions</title><title level="j" type="abbrev">Cathet. Cardiovasc. Intervent.</title><idno type="ISSN">1522-1946</idno><idno type="eISSN">1522-726X</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>New York</pubPlace><date type="published" when="2002-10">2002-10</date><biblScope unit="volume">57</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="125">125</biblScope><biblScope unit="page" to="134">134</biblScope></imprint><idno type="ISSN">1522-1946</idno></series><idno type="istex">277C98683DDCBFAB6C9EC1429C50BC9A677EBA2D</idno><idno type="DOI">10.1002/ccd.10313</idno><idno type="ArticleID">CCD10313</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1522-1946</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>distal protection</term><term>saphenous vein graft</term><term>stenting</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) and native coronary arteries may be associated with embolization of particulate debris into the distal microcirculation. The FilterWire uses a polyurethane filter bag contained on a radiopaque loop to trap embolic debris during native vessel and SVG intervention. The objectives of this study were to assess the feasibility and safety of the FilterWire during PCI and to examine the size and content of the particulate debris captured during SVG and native vessel intervention. Early angiographic, in‐hospital, and 30‐day clinical outcomes were reviewed in 35 patients with 36 lesions treated with the FilterWire during PCI. Lesions were located in 22 (61%) native coronary arteries and in 14 (39%) SVGs. Multivessel coronary artery disease was present in 75% of patients. Lesions were complex (ACC/AHA complexity B2 or C) in 81% of cases. The FilterWire was successfully delivered and deployed distal to the site of coronary intervention in 92% of lesions, including 95% of native vessels and 82% of SVG lesions. Embolic debris was entrapped in 82% of these cases. The average particulate debris had a mean major axis of 490 μm (range, 45–3,302 μm) and minor axis of 226 μm (range, 33–1,677 μm). Although reduced flow was common (36.1%) when the FilterWire was in place, there were no sustained episodes of abrupt closure and only one (2.8%) patient developed sustained no‐reflow after FilterWire removal. Distal branch vessel embolization was found in four (11.1%) cases. Major adverse cardiac events occurred in 5 (14%) of 35 patients treated with the device, although 2 of these patients were evolving an acute myocardial infarction at the time of the procedure; in patients meeting the prospectively defined inclusion criteria, the major adverse cardiac event was 6%. These results suggest that the FilterWire is a feasible and safe method of collecting particulate debris released during SVG and native vessel coronary intervention. Its benefit over conventional therapy and other distal protection devices is currently under study. Cathet Cardiovasc Intervent 2002;57:125–134. © 2002 Wiley‐Liss, Inc.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Jeffrey J. Popma MD</name><affiliations><json:string>Department of Internal Medicine, Cardiovascular Divisions, Brigham and Women's Hospital, Boston, Massachusetts</json:string><json:string>Interventional Cardiology, Brigham and Women's Hospital, 75 Francis Street, L‐2 Catheterization Laboratory, Boston, MA 02115</json:string></affiliations></json:item><json:item><name>Nicholas Cox</name><affiliations><json:string>Department of Internal Medicine, Cardiovascular Divisions, Brigham and Women's Hospital, Boston, Massachusetts</json:string></affiliations></json:item><json:item><name>K. Eugene Hauptmann</name><affiliations><json:string>Krankenhaus D. Barmh Bruder, Trier, Germany</json:string></affiliations></json:item><json:item><name>Nicolaus Reifart MD</name><affiliations><json:string>Kardiologisches Institut Main‐Taunus, Taunus, Germany</json:string></affiliations></json:item><json:item><name>Renu Virmani MD</name><affiliations><json:string>Armed Forces Institute of Pathology, Washington, D.C</json:string></affiliations></json:item><json:item><name>Khaled Emira MD</name><affiliations><json:string>Department of Internal Medicine, Cardiovascular Divisions, Brigham and Women's Hospital, Boston, Massachusetts</json:string></affiliations></json:item><json:item><name>Sabina Murphy</name><affiliations><json:string>Harvard Clinical Research Institute, Boston, Massachusetts</json:string></affiliations></json:item><json:item><name>C. Michael Gibson MD</name><affiliations><json:string>Harvard Clinical Research Institute, Boston, Massachusetts</json:string></affiliations></json:item><json:item><name>Eberhard Grube MD</name><affiliations><json:string>Heart Center, Siegburg, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>saphenous vein graft</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>stenting</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>distal protection</value></json:item></subject><articleId><json:string>CCD10313</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) and native coronary arteries may be associated with embolization of particulate debris into the distal microcirculation. The FilterWire uses a polyurethane filter bag contained on a radiopaque loop to trap embolic debris during native vessel and SVG intervention. The objectives of this study were to assess the feasibility and safety of the FilterWire during PCI and to examine the size and content of the particulate debris captured during SVG and native vessel intervention. Early angiographic, in‐hospital, and 30‐day clinical outcomes were reviewed in 35 patients with 36 lesions treated with the FilterWire during PCI. Lesions were located in 22 (61%) native coronary arteries and in 14 (39%) SVGs. Multivessel coronary artery disease was present in 75% of patients. Lesions were complex (ACC/AHA complexity B2 or C) in 81% of cases. The FilterWire was successfully delivered and deployed distal to the site of coronary intervention in 92% of lesions, including 95% of native vessels and 82% of SVG lesions. Embolic debris was entrapped in 82% of these cases. The average particulate debris had a mean major axis of 490 μm (range, 45–3,302 μm) and minor axis of 226 μm (range, 33–1,677 μm). Although reduced flow was common (36.1%) when the FilterWire was in place, there were no sustained episodes of abrupt closure and only one (2.8%) patient developed sustained no‐reflow after FilterWire removal. Distal branch vessel embolization was found in four (11.1%) cases. Major adverse cardiac events occurred in 5 (14%) of 35 patients treated with the device, although 2 of these patients were evolving an acute myocardial infarction at the time of the procedure; in patients meeting the prospectively defined inclusion criteria, the major adverse cardiac event was 6%. These results suggest that the FilterWire is a feasible and safe method of collecting particulate debris released during SVG and native vessel coronary intervention. Its benefit over conventional therapy and other distal protection devices is currently under study. 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The FilterWire uses a polyurethane filter bag contained on a radiopaque loop to trap embolic debris during native vessel and SVG intervention. The objectives of this study were to assess the feasibility and safety of the FilterWire during PCI and to examine the size and content of the particulate debris captured during SVG and native vessel intervention. Early angiographic, in‐hospital, and 30‐day clinical outcomes were reviewed in 35 patients with 36 lesions treated with the FilterWire during PCI. Lesions were located in 22 (61%) native coronary arteries and in 14 (39%) SVGs. Multivessel coronary artery disease was present in 75% of patients. Lesions were complex (ACC/AHA complexity B2 or C) in 81% of cases. The FilterWire was successfully delivered and deployed distal to the site of coronary intervention in 92% of lesions, including 95% of native vessels and 82% of SVG lesions. Embolic debris was entrapped in 82% of these cases. The average particulate debris had a mean major axis of 490 μm (range, 45–3,302 μm) and minor axis of 226 μm (range, 33–1,677 μm). Although reduced flow was common (36.1%) when the FilterWire was in place, there were no sustained episodes of abrupt closure and only one (2.8%) patient developed sustained no‐reflow after FilterWire removal. Distal branch vessel embolization was found in four (11.1%) cases. Major adverse cardiac events occurred in 5 (14%) of 35 patients treated with the device, although 2 of these patients were evolving an acute myocardial infarction at the time of the procedure; in patients meeting the prospectively defined inclusion criteria, the major adverse cardiac event was 6%. These results suggest that the FilterWire is a feasible and safe method of collecting particulate debris released during SVG and native vessel coronary intervention. Its benefit over conventional therapy and other distal protection devices is currently under study. 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Michael</givenNames><familyName>Gibson</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af6"><personName><givenNames>Eberhard</givenNames><familyName>Grube</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Department of Internal Medicine, Cardiovascular Divisions, Brigham and Women's Hospital, Boston, Massachusetts</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="DE" type="organization"><unparsedAffiliation>Krankenhaus D. Barmh Bruder, Trier, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="DE" type="organization"><unparsedAffiliation>Kardiologisches Institut Main‐Taunus, Taunus, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="US" type="organization"><unparsedAffiliation>Armed Forces Institute of Pathology, Washington, D.C</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="US" type="organization"><unparsedAffiliation>Harvard Clinical Research Institute, Boston, Massachusetts</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="DE" type="organization"><unparsedAffiliation>Heart Center, Siegburg, Germany</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">saphenous vein graft</keyword><keyword xml:id="kwd2">stenting</keyword><keyword xml:id="kwd3">distal protection</keyword></keywordGroup><fundingInfo><fundingAgency>Boston Scientific‐EPI, Santa Clara, CA</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) and native coronary arteries may be associated with embolization of particulate debris into the distal microcirculation. The FilterWire uses a polyurethane filter bag contained on a radiopaque loop to trap embolic debris during native vessel and SVG intervention. The objectives of this study were to assess the feasibility and safety of the FilterWire during PCI and to examine the size and content of the particulate debris captured during SVG and native vessel intervention. Early angiographic, in‐hospital, and 30‐day clinical outcomes were reviewed in 35 patients with 36 lesions treated with the FilterWire during PCI. Lesions were located in 22 (61%) native coronary arteries and in 14 (39%) SVGs. Multivessel coronary artery disease was present in 75% of patients. Lesions were complex (ACC/AHA complexity B2 or C) in 81% of cases. The FilterWire was successfully delivered and deployed distal to the site of coronary intervention in 92% of lesions, including 95% of native vessels and 82% of SVG lesions. Embolic debris was entrapped in 82% of these cases. The average particulate debris had a mean major axis of 490 μm (range, 45–3,302 μm) and minor axis of 226 μm (range, 33–1,677 μm). Although reduced flow was common (36.1%) when the FilterWire was in place, there were no sustained episodes of abrupt closure and only one (2.8%) patient developed sustained no‐reflow after FilterWire removal. Distal branch vessel embolization was found in four (11.1%) cases. Major adverse cardiac events occurred in 5 (14%) of 35 patients treated with the device, although 2 of these patients were evolving an acute myocardial infarction at the time of the procedure; in patients meeting the prospectively defined inclusion criteria, the major adverse cardiac event was 6%. These results suggest that the FilterWire is a feasible and safe method of collecting particulate debris released during SVG and native vessel coronary intervention. Its benefit over conventional therapy and other distal protection devices is currently under study. Cathet Cardiovasc Intervent 2002;57:125–134. © 2002 Wiley‐Liss, Inc.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Initial clinical experience with distal protection using the FilterWire in patients undergoing coronary artery and saphenous vein graft percutaneous intervention</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>FilterWire During Percutaneous Intervention</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Initial clinical experience with distal protection using the FilterWire in patients undergoing coronary artery and saphenous vein graft percutaneous intervention</title></titleInfo><name type="personal"><namePart type="given">Jeffrey J.</namePart><namePart type="family">Popma</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Internal Medicine, Cardiovascular Divisions, Brigham and Women's Hospital, Boston, Massachusetts</affiliation><affiliation>Interventional Cardiology, Brigham and Women's Hospital, 75 Francis Street, L‐2 Catheterization Laboratory, Boston, MA 02115</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nicholas</namePart><namePart type="family">Cox</namePart><affiliation>Department of Internal Medicine, Cardiovascular Divisions, Brigham and Women's Hospital, Boston, Massachusetts</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">K. Eugene</namePart><namePart type="family">Hauptmann</namePart><affiliation>Krankenhaus D. Barmh Bruder, Trier, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nicolaus</namePart><namePart type="family">Reifart</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Kardiologisches Institut Main‐Taunus, Taunus, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Renu</namePart><namePart type="family">Virmani</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Armed Forces Institute of Pathology, Washington, D.C</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Khaled</namePart><namePart type="family">Emira</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Internal Medicine, Cardiovascular Divisions, Brigham and Women's Hospital, Boston, Massachusetts</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sabina</namePart><namePart type="family">Murphy</namePart><affiliation>Harvard Clinical Research Institute, Boston, Massachusetts</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C. Michael</namePart><namePart type="family">Gibson</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Harvard Clinical Research Institute, Boston, Massachusetts</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Eberhard</namePart><namePart type="family">Grube</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Heart Center, Siegburg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">New York</placeTerm></place><dateIssued encoding="w3cdtf">2002-10</dateIssued><dateCaptured encoding="w3cdtf">2001-12-12</dateCaptured><dateValid encoding="w3cdtf">2002-06-05</dateValid><copyrightDate encoding="w3cdtf">2002</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">3</extent><extent unit="tables">7</extent><extent unit="references">27</extent><extent unit="words">6426</extent></physicalDescription><abstract lang="en">Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) and native coronary arteries may be associated with embolization of particulate debris into the distal microcirculation. The FilterWire uses a polyurethane filter bag contained on a radiopaque loop to trap embolic debris during native vessel and SVG intervention. The objectives of this study were to assess the feasibility and safety of the FilterWire during PCI and to examine the size and content of the particulate debris captured during SVG and native vessel intervention. Early angiographic, in‐hospital, and 30‐day clinical outcomes were reviewed in 35 patients with 36 lesions treated with the FilterWire during PCI. Lesions were located in 22 (61%) native coronary arteries and in 14 (39%) SVGs. Multivessel coronary artery disease was present in 75% of patients. Lesions were complex (ACC/AHA complexity B2 or C) in 81% of cases. The FilterWire was successfully delivered and deployed distal to the site of coronary intervention in 92% of lesions, including 95% of native vessels and 82% of SVG lesions. Embolic debris was entrapped in 82% of these cases. The average particulate debris had a mean major axis of 490 μm (range, 45–3,302 μm) and minor axis of 226 μm (range, 33–1,677 μm). Although reduced flow was common (36.1%) when the FilterWire was in place, there were no sustained episodes of abrupt closure and only one (2.8%) patient developed sustained no‐reflow after FilterWire removal. Distal branch vessel embolization was found in four (11.1%) cases. Major adverse cardiac events occurred in 5 (14%) of 35 patients treated with the device, although 2 of these patients were evolving an acute myocardial infarction at the time of the procedure; in patients meeting the prospectively defined inclusion criteria, the major adverse cardiac event was 6%. These results suggest that the FilterWire is a feasible and safe method of collecting particulate debris released during SVG and native vessel coronary intervention. Its benefit over conventional therapy and other distal protection devices is currently under study. Cathet Cardiovasc Intervent 2002;57:125–134. © 2002 Wiley‐Liss, Inc.</abstract><note type="funding">Boston Scientific‐EPI, Santa Clara, CA</note><subject lang="en"><genre>keywords</genre><topic>saphenous vein graft</topic><topic>stenting</topic><topic>distal protection</topic></subject><relatedItem type="host"><titleInfo><title>Catheterization and Cardiovascular Interventions</title></titleInfo><titleInfo type="abbreviated"><title>Cathet. Cardiovasc. Intervent.</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>Original Study</topic></subject><identifier type="ISSN">1522-1946</identifier><identifier type="eISSN">1522-726X</identifier><identifier type="DOI">10.1002/(ISSN)1522-726X</identifier><identifier type="PublisherID">CCD</identifier><part><date>2002</date><detail type="volume"><caption>vol.</caption><number>57</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>125</start><end>134</end><total>10</total></extent></part></relatedItem><relatedItem type="preceding"><titleInfo><title>Catheterization and Cardiovascular Diagnosis</title></titleInfo><identifier type="ISSN">0098-6569</identifier><identifier type="ISSN">1097-0304</identifier><part><date point="end">1998</date><detail type="volume"><caption>last vol.</caption><number>45</number></detail><detail type="issue"><caption>last no.</caption><number>4</number></detail></part></relatedItem><identifier type="istex">277C98683DDCBFAB6C9EC1429C50BC9A677EBA2D</identifier><identifier type="DOI">10.1002/ccd.10313</identifier><identifier type="ArticleID">CCD10313</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2002 Wiley‐Liss, Inc.</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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