Trends in utilization and clinical outcomes with and without the use of distal filter wire embolic protection devices

• Published in: Cardiovascular revascularization medicine 2024-10
• Main Authors: Scully, Timothy G., Roberts, Louise, Dinh, Diem, Brennan, Angela, Clark, David, Ajani, Andrew, Reid, Christopher M., Oqueli, Ernesto, Hiew, Chin, Stub, Dion, Chandrasekhar, Jaya, Freeman, Melanie
• Format: Article
• Language: English
• Subjects: Embolic protection; PCI; Saphenous vein graft
• ISSN: 1553-8389; 1878-0938; 1878-0938
• DOI: 10.1016/j.carrev.2024.10.008

Embolic protection devices were developed to reduce the risk of common complications encountered during percutaneous coronary intervention (PCI) of saphenous vein grafts, however, in the setting of contemporary multi-modality medical management, their overall efficacy has been called into question. This study aimed to assess the evolving utilization and clinical outcomes associated with distal filter wire embolic protection devices in saphenous vein PCI. Consecutive patients undergoing PCI to a saphenous vein graft in a registry were included. Peri-procedural and long-term outcomes including 12-month mortality and 30-day MACCE rates were compared between PCI using a distal filter wire embolic protection device and unprotected PCI. From 2005 to 2020, a total of 753 patients underwent PCI to a saphenous vein graft with 256 using a distal filter wire embolic protection device. At one year, the use of a distal filter wire embolic protection devices was not associated with a decrease in mortality (4.7 % vs 5.4 %, p = 0.19) and there was no difference in 30-day MACCE rates between protected and unprotected saphenous vein PCI (3.1 % vs 5.8 %, p = 0.10). In this 12-month analysis of saphenous vein graft PCI, there was no evidence that distal filter wire embolic protection devices improved short term post procedural or long-term mortality outcomes. •Distal filter wire embolic protection did not improve short term MACCE.•Additionally there was no association with longer term improved survival.•These findings are consistent with other large real-world registries.