[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: Enrico Cerrato, Cristina Rolfo, Francesco Tomassini, Nicolò Montali, Alfonso Gambino, Vincenzo Infantino, Sara Palacio Restrepo, Denise Baricocchi, Rosa Nevola, Andrea Gagnor, Ferdinando Varbella
• Journal: Giornale italiano di cardiologia (2006) (G Ital Cardiol (Rome)) Vol. 16 Issue 6 Pg. 373-9 (Jun 2015) ISSN: 1827-6806 [Print] Italy
• Vernacular Title: MGuard "Dacron mesh covered" stent per il trattamento della sindrome coronarica acuta con sopraslivellamento del tratto ST in presenza di elevato carico trombotico: outcome intraospedaliero e a lungo termine in un singolo centro ad alto volume.
• PMID: 26156698 (Publication Type: Journal Article)

Chemical References

• Anticoagulants
• Polyethylene Terephthalates

Topics

• Aged
• Anticoagulants (therapeutic use)
• Combined Modality Therapy
• Coronary Angiography
• Coronary Circulation
• Coronary Thrombosis (complications, diagnostic imaging, drug therapy, surgery)
• Equipment Design
• Female
• Hospitals, Special
• Humans
• Male
• Middle Aged
• Myocardial Infarction (etiology, physiopathology, surgery)
• Percutaneous Coronary Intervention (adverse effects, instrumentation)
• Polyethylene Terephthalates
• Postoperative Complications (etiology, prevention & control)
• Prospective Studies
• Severity of Illness Index
• Stents (adverse effects)
• Surface Properties
• Thromboembolism (etiology, prevention & control)
• Treatment Outcome