The primary endpoint was ST-segment resolution at 60–90 minutes. Follow-up was at 30 days, six months and one year. 3 Participants were randomised to PCI with bare metal stent (BMS) or drug-eluting stent (DES), (n=216) or to PCI with MGuard (n=217).
#CHORONARY MGUARD PRIME MGP4028 TRIAL#
The MGuard for Acute ST Elevation Reperfusion (MASTER) trial recruited 432 patients with symptoms consistent with STEMI within 12 hours of symptom onset, at 50 sites in nine countries. Case reports in patients with STEMI undergoing primary PCI have demonstrated the ability of the MGuard EPS to capture and contain (‘jail’) thrombus and atheroma behind its net, thereby preventing distal embolisation (see Figure 2). The EPS has evolved from the stainless steel MGuard to the L605 cobalt chromium MGuard Prime, both featuring a polyethylene terephthalate (PET) mesh with 150–180 μm aperture size, preventing the prolapse of thrombus and potential distal embolisation (see Figure 1). The MGuard™ Embolic Protection Stent (EPS) is a novel device. 2 Even if aspiration is good, embolisation remains an ongoing issue. However, the Thrombus Aspiration during ST-segment Elevation myocardial infarction (TASTE) study (n= 7244) found that routine thrombus aspiration before PCI as compared with PCI alone did not result in a reduction in 30-day mortality. 1 Results showed a reduction in all-cause mortality at 30 days. The Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study (TAPAS), prospective randomised trial, aimed to determine whether aspiration of thrombotic material before stent implantation of the infarct-related coronary artery resulted in improved myocardial perfusion compared with conventional primary PCI. Therapeutic Alternatives for Intracoronary Thrombus – MASTER Results in Perspectiveĭr Abizaid began by emphasising the need for therapeutic alternatives to avoid distal thromboembolism (embolisation) during highly thrombotic situations such as STEMI.
#CHORONARY MGUARD PRIME MGP4028 UPDATE#
These presentations aimed to discuss the importance of thrombus management in PCI for STEMI patients, to give an update of relevant clinical data on the performance of the MGuard™ stent in STEMI patients and to present real life examples on how this device selection can influence the outcome in STEMI patients. A symposium was sponsored by Inspire MD and chaired by Alexandre Abizaid, Institute Dante Pazzanese de Cardiologia (Sao Paulo, Brazil), and Jean Fajadet, Clinique Patteur, (Toulouse, France). Unfortunately, there is a lack of significant adjunctive devices to protect the microcirculation. This may lead to distal vessel occlusion resulting in impaired myocardial perfusion, which is associated with larger infarct size, incomplete ST resolution and increased mortality. This report of the proceedings of a symposium at EuroPCR, 20–, Paris, France, discussed clinical trial data, as well as a number of clinical cases, illustrating the utility of the MGuard EPS in difficult situations.Įmbolisation of atherothrombotic material is a common occurrence during percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI). Data from the andomised Safety and Efficacy Study of MGuard Stent After a Heart Attack (MASTER II) trial and from a real-life registry have shown the efficacy and safety of the MGuard in primary PCI. When used in acute STEMI, the MGuard EPS shows significant improvement in myocardial flow and ST resolution, even in complicated clinical cases vs the standard approach with conventional bare metal or drug-eluting stents. The MGuard™ embolic protection stent (EPS) features a unique polymer micronet mesh coating. This causes microvascular occlusions, leading to a further reduction in myocardial reperfusion. Distal embolisation of atherothrombotic material is a frequent consequence of percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI).
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