![]() ![]() A 4-mm Amplatz GooseNeck® snare kit (ev3 Endovascular, Inc. On withdrawal, the MGS was trapped in the RCA ( Fig. 1 C). After several attempts, the MGS could not be traversed and the decision to pre-dilate the lesion was taken. We decided to place an MG 3–28 stent, without pre-dilation to avoid dislodging the clot. Minneapolis, MN, USA), a critical lesion was observed with a long clot behind it ( Fig. 1 B). After the guide catheter was introduced (AR2 guide catheter: Launcher® Medtronic, Inc. Angiography was performed, revealing right coronary artery (RCA) occlusion ( Fig. 1 A ). Male, 79 years of age with diabetes, hypertension and hyperlipidemia, presented due to ST elevation myocardial infarction (STEMI) of three hours duration. ![]() We describe the strategies that can be used and considerations regarding the selection of appropriate lesions and the adequate methodology for the use of the MGS. The device could be retrieved in both cases. We present two cases in which the MGS could not cross the lesion and, in the attempt to withdraw it, was trapped in the coronary artery (both the stent and the mesh). When a clot is formed beyond severe lesions or in very tortuous coronary arteries, the delivery and navigability capacities of this stent are compromised. Nevertheless, there are limitations in the navigability of the MGS, due to its design consisting of a polymer layer or membrane fused to the outer surface. It has been used primarily in acute myocardial infarction for the treatment of unstable plaques associated with blood clotting, particularly in acute myocardial infarction, but also in saphenous vein graft, acute intrastent thrombosis and even in the treatment of coronary perforations. The aim is to avoid embolization of the clot and its consequences, such as reduced TIMI flow and several situations ranging from a slight coronary flow reduction to a severe myocardial blush impairment. The MGS device is compatible with 6-French guiding catheters and 0.014-inch guidewires. The strut thickness is 80 μm and the crossing profile is 1.0 mm (from 2.75 to 3.0 mm) and 1.2 mm (from 3.25 to 4.00 mm). Due to its reduced size, it acts as a retaining filter for potential clots and plaque debris that could become detached when implanting the device. Both components are firmly bound on their distal ends, and are assembled on a semicompliant coronary angioplasty balloon. This is weaved with a unique thread of PET (polyethylene terephthalate) with a fiber width of 20 μm. The MGuard Prime Stent (MGS) consists of a bare metal stent platform made of a cobalt chromium alloy with a micronet sleeve coating attached to its outer surface. The MGuard Stent (MGS) (Inspire MD, Ltd., Tel Aviv, Israel) is a conventional bare metal stent covered by a thin polymer mesh on its external surface, designed to trap the clot between the stent and vessel wall. These cases illustrate the need for careful selection of the lesions that are going to be treated with this type of stent, for which pre-dilatation is recommended in severe lesions located just after an acute vessel angle, the evaluation of proximal angulation and calcification, as well as strategies for complete retrieval in case of implantation failure. Complete retrieval was possible in both cases. In the Investigator's opinion the lesion/vessel is unsuitable for treatment with the MGuard™ Prime Embolic Protection Stent System for any reason.We present two cases of right coronary artery occlusion in which MGuard® stent implantation failed for different causes, leading to a retrieval procedure adapted to the situation.Target lesion involves a bifurcation with a side branch >/=2.0 mm in diameter.Co-morbid condition(s) or others that could limit the subject's ability to participate in the trial or to comply with follow-up requirements, or impact the scientific integrity of the trial.Subject is experiencing clinical symptoms consistent with ST elevation acute myocardial infarction (STEMI) of >30 minutes and 30 minutes, or requiring IV pressors or intra-aortic balloon bump (IABP) or other hemodynamic support device for hypotension).Why Should I Register and Submit Results?. ![]()
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