Thrombus During SVG PCI, aggressive backup support is typically not necessary unless the lesion is very distal or delivery of an embolic protectionThe first such device was the Percusurge Guardwire system, which consisted of a compliant balloon inflated distal to the SVG lesion to occlude flow during PCI and an aspiration catheter to remove the resulting debrisThis device was formally evaluated in the pivotal SAFER trial (Saphenous Vein Graft Angioplasty Free of Emboli Randomized), 4 Introduction. In the European Society of Cardiology and European Association for Cardiovascular Surgery downgraded the recommendation for the use of embolic protection devices (EPDs) in saphenous vein graft (SVG) lesions from Class I to Class IIa, because “although a single randomized trial supports the use of distal embolic protection during SVG percutaneous coronary intervention (PCI· Causes of incomplete embolic protection include large device crossing profile causing plaque disruption, device-mediated intimal trauma, incomplete conduit occlusion or filter apposition, filter movement, incomplete aspiration, filter pore size discrepancy (either too large or small), filter embolic overload, side branch backwash, delayed platelet-white cell embolization from the target site, and release of soluble mediators · Background: Evidence concerning the efficacy of the embolic protection devices (EPDs) in saphenous vein graft (SVG) percutaneous coronary intervention (PCI) is sparse. The study was designed to compare major cardiovascular events of all-comer population of SVG PCI with and without EPDs at one year of follow-up · A large National Cardiovascular Data Registry (NCDR) CathPCI registry showed no benefits in routine use of embolic protection devices during saphenous vein graft intervention, rather a slightly higher incidence of periprocedural complications noted in the embolic protection device groupMoreover, in the recent era, no-reflow and periprocedural following percutaneous coronary intervention (PCI) in saphenous vein grafts (SVG) with and without embolic protection devices (EPD) There are three main types of EPDs employed in SVG intervention: distal filtration, distal balloon occlusion, and proximal occlusion devices.

Background: Evidence concerning the efficacy of the embolic protection devices (EPDs) in saphenous vein graft (SVG) percutaneous coronary intervention (PCI) Based on data from vein graft interventions, the study found that an embolic protection device was used in % of cases, with significant With the updated guidelines, physicians are not mandated to use embolic protection devices in saphenous vein graft intervention in every case Saphenous Vein Graft (SVG) InterventionsThe SpiderFX™ Embolic Protection Device is indicated for use as an embolic protection system to contain and removeMethods and results: A multi-center registry comparing PCI with and without EPDs in Use of embolic protection was associated with reduced risk of unsuccessful intervention (odds ratio, ;% credible interval,) and day mortality (odds ratio, ;% credible interval,). Circulation; – doi: /CIRC The clinical benefit of percutaneous intervention (PCI) depends on both angiographic success at the site of intervention as well as the restoration of adequate microvascular perfusion. Leading San Antonio Vein Specialists. The study was designed to compare major cardiovascular events of all-comer population of SVG PCI with and without EPDs at one year of follow-up. Schedule a Free Consult! Conclusions: Use of embolic protection is decreasing with time and occurs in less than half of vein graft interventions · The Proximal Protection During Saphenous Vein Graft Interventions Using the Proxis Embolic Protection System (PROXIMAL) trial compared the Proxis device in SVG PCI to distal protection devices and demonstrated noninferiority in preventing day MACE,but the device is currently cleared only for “flow control” during interventionRandomized trial of a distal embolic protection device during percutaneous intervention of saphenous vein aorto-coronary bypass grafts. Saphenous vein graft intervention is commonly associated with evidence of distal plaque embolization, which is correlated with worse clinical outcomes The ACC/AHA and older ESC guidelines give the use of embolic protection devices a class I indication for saphenous vein graft intervention when technically feasibleThe guideline recommendations are based on only one randomised controlled trial that was published in and only has day outcomes dataThe embolic protection device that was used in this trial is not used anymore Background: Evidence concerning the efficacy of the embolic protection devices (EPDs) in saphenous vein graft (SVG) percutaneous coronary intervention (PCI) is sparse.

The first embolic protection device that underwent testing in degenerated saphenous vein grafts was the PercuSurge GuardWire (Medtronic) in the Saphenous Vein Boston Scientific Corporation, FilterWire EZ –mm Embolic Protection System, Filter, Distal, Saphenous vein graft and carotid interventions impact of anti-embolic protection devices on long-term outcomes was obed, as atyear, the incidence of one or more total saphenous vein graft DecMost patients who undergo coronary artery bypass graft (CABG) surgery receiveThrombolysis and thrombectomy · Embolic protection devicesYet The distal occlusion devices have a large evidence base with early vein graft intervention studies using the GuardWire (Medtronic AVE, Santa Rosa, California) The limiting factor in coronary artery bypass surgery is the relatively rapid progression of atheromatous disease in the saphenous vein grafts. The Embolic Protection Transluminally with the FilterWire EZ Device in Saphenous Vein Grafts (BLAZE) registry reported that the success rate of this device was %, and day MACE rate was % due entirely to non-Q-wave MI The PRIDE (PRotection during saphenous vein graft Intervention to prevent Distal Embolization) study was a prospective trial randomizing patients with SVG lesions to distal embolic protection with the TriActiv System ver-sus a control group that used either the GuardWire or FilterWire EX. Thirty-day MACE was % for the TriActiv Catheter-based intervention in saphenous venous aorto-coronary bypass grafts carries a significant (≈20%) risk of a major adverse clinical event (MACE) (predominantly myocardial infarction) or reduced antegrade flow (the no-reflow phenomenon)Several mechanisms have been offered, including spasm of the distal microcirculation, platelet clumpiThe high risk of periprocedural myocardial infarction and MACE during vein graft intervention led to exploration of embolic protection devices in this setting. Distal occlusion devices. Greater than one-half of these vein grafts will fail byyears, and the risks associated with repeat coronary artery bypass surgery are significantly greater than that of the initial surgery.

associated with saphenous vein graft intervention, embolization is increasingly recognized inDistal protection devices (DPDs) were first introduced for Protect Against Distal Embolization · Embolic Complications are Frequent and Costly in SVG Interventions · Embolic Protection Devices are Underutilized · Join OurRequest information. The diameter of the artery at the site of filter basket placement should be between mm and mm Ad Medtronic offers multiple vascular embolization solutions. Detachable coils and vascular plugs for the embolization of the peripheral vasculature · The latest guidelines recommend using embolic protection devices (EPD) as a Class I indication (with the level of evidence B) for the saphenous vein grafts (SVG) intervention whenever possible and technically feasible for minimizing the distal embolization (3) The SpiderFX embolic protection device is indicated for use as a guidewire and embolic protection system to contain and remove embolic material (thrombus/debris) while performing angioplasty and stenting procedures in carotid arteries.