A vigilance study of distal protection device used during percutaneous coronary interventions

Article type: Research Article

Authors: Shah, Kanan | Parikh, Keyur | Chag, Milan | Shah, Urmil | Chandarana, Anish | Baxi, Hemang | Naik, Ajay | Goyal, Ramesh K.^;

Affiliations: L.J. Institute of Pharmacy, Ahmedabad, India | Care Cardiovascular Consultants Pvt Ltd, Ahmedabad, India | L.M. College of Pharmacy, Ahmedabad, India

Note: [] Corresponding author. E-mail: [email protected].

Abstract: In the light of increased incidences of cardiovascular diseases world wide, there is also an increase in number of percutaneous interventions (PCI) and many new devices are introduced that may be expensive. Distal Protection Device (DPD) is one of them with costs that are twice those of conventional devices. In the present study we evaluated the usefulness of DPD after acute coronary syndrome (ACS) in patients undergoing PTCA and to analyze the effect on major adverse cardiac events (MACE) at the end of three months and consider its requirement as compared to the conventional stents. 109 patients with ACS were divided into two groups: PTCA done using DPD and PTCA done without DPD. Patients having active significant bleeding, major surgery within the previous six weeks or those who were participating in other trials using investigational drugs or devices were excluded. All patients without DPD required the administration of intracoronary (IC) adenosine and sodium nitroprusside to avoid no-reflow but in patients with DPD only 7.7% patients required IC vasodilators. In patients with DPD only 29% patients required the additional use of glycoprotein IIb/IIIa (Gp IIb/IIIa) receptor antagonists as compared to 100% usage in patients without DPD. On studying the MACE data it was found that amongst the patients with DPD no patient had either dysnea or needed repeat revascularization or urgent Coronary Artery Bypass Grafting (CABG). Amongst the patients without DPD four patients had angina and one had dysnea. In conclusion, although one can suggest that the use of DPD is safe and, it cannot be used indiscriminately because it is an expensive modality.

Journal: International Journal of Risk and Safety in Medicine, vol. 18, no. 4, pp. 205-212, 2006