Impact of a micro‐net mesh technology covering stent on coronary microvascular dysfunction in patients with high thrombus burden. Issue 2 (31st May 2021)

• Record Type: Journal Article
• Authors: Noirclerc, Nathalie; Marliere, Stephanie; Bakhti, Akader; Mangin, Lionel; Cassar, Emmanuel; Vautrin, Estelle; Piliero, Nicolas; Ormezzano, Olivier; Bouvaist, Helene; Riou, Laurent; Vanzetto, Gerald; Belle, Loic; Barone‐Rochette, Gilles
• Is Part Of: Catheterization and cardiovascular interventions. Volume 99:Issue 2(2022)
• Page Start: 397
• Page End: 404
• Publication Date: 2021-05-31
• Subjects: coronary microvascular dysfunction -- coronary thrombus -- percutaneous coronary intervention -- stent technology; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.29782
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Background: Highly thrombotic coronary lesions continue to be a serious and clinically significant problem that is not effectively and completely addressed by current technology. Objectives: We aimed to investigate whether a micro‐net mesh (MNM) technology covering stent could preserve the index of microcirculatory resistance (IMR) after percutaneous coronary intervention (PCI) in patients with high thrombus burden. Methods and Results: Fifty‐two patients with non‐ST elevation myocardial infarction or ST Elevation Myocardial Infarction and high thrombus burden (TIMI thrombus grade ≥ 3) were randomized into two groups, PCI with a MNM covering stent (MNM group, n = 25) and PCI with any commercially available stent (DES group, n = 27). As the primary endpoint, IMR was measured immediately after PCI using a pressure–temperature sensor‐tipped coronary wire. The secondary endpoint was left ventricular ejection fraction (LVEF) at 6 months of follow‐up. The IMR in the MNM group was significantly lower in comparison to the DES group (33.2 [21.3, 48.9] vs. 57.2 [39.9, 98.0], p = 0.005). No significant differences were observed in baseline LVEF (54.5 ± 10.2% vs. 53.1 ± 6.87%, p = .57), while LVEF was significantly improved at follow‐up in the MNM group (61.1 ± 7.1% vs. 53.9 ± 6.35%, p = .0001). Conclusion: MNM technology significantly improved coronary microvascular dysfunction after PCI in patient with acute coronary syndrome and appears as a useful technological option for thrombus management.