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Mike Stanley

Distal Embolic Protection: An Innovative Approach to Combat Acute Ischemic Events during Percutaneous Coronary Interventions in SVGs. Mike Stanley Presentation for Research in Allied Health, East Tennessee State University, Johnson City, Tennessee. December 1, 2005.

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Mike Stanley

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  1. Distal Embolic Protection: An Innovative Approach to Combat Acute Ischemic Events during Percutaneous Coronary Interventions in SVGs Mike Stanley Presentation for Research in Allied Health, East Tennessee State University, Johnson City, Tennessee. December 1, 2005.

  2. Growing Need for Distal Protection • The numbers of coronary bypass surgeries are increasing every year. • The nature of saphenous vein graphs leads to initial and repeat percurtaneous coronary interventions (PCIs) to restore proper blood flow. • The risks of PCI in SVGs include stroke, myocardial infarction, and death. • Previous studies have shown a MACE rate (composite of death, MI, emergent bypass surgery, and target vessel revascularization) of 20%.

  3. Distal Embolic Protection • Over the last five years, distal embolic protection has been researched and utilized to prevent acute ischemic events during PCI in SVGs. • It is accomplished by occluding the target vessel by a balloon catheter downstream from the lesion site. The PCI is performed and an aspiration device cleans the vessel before the balloon is deflated. This removes any embolic debris from the vessel. The entire system is then removed.

  4. Distal Protection (Cont.) • The fist definitive trial to measure MACE rates utilized the PercuSurge GuardWire System (Medtronic Inc.). The results showed a MACE rate of 11.2% (compared to 20% without protection). • The PRIDE trial used Kensey Nash’s TriActive System and showed a MACE rate of 10.2%. • The most recent studies have shown MACE rates as low as 6% and 2%.

  5. Conclusions • The need for distal embolic protection has been shown to be great. • The results of studies so far have been very encouraging. • MACE rates will likely improve as physician familiarity and technologies improve. • Giving patients alternatives and the best possible care should be the goal of all healthcare workers. • The development of distal embolic protection has empowered many healthcare workers with the assurance they are providing the best and most advanced care.

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