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Adjunctive Devices for Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention

Slide: 31 of 39

Adjunctive Distal Filter Embolic Protection Devices Versus PCI Alone in Patients With STEMI: All Outcomes

In RCTs, the use of distal filter embolic protection devices did not significantly impact mortality, MI, stroke, or MACE versus a control when using the longest duration of followup. However the use of a distal filter device significantly increased the risk of target revascularization. Using the risk difference [RD 0.04 (-0.0006, 0.08), (CER 0 to 0.09)], 1 case of target revascularization would occur with the use of a distal filter embolic protection device in 25 cases. In RCTs, the use of distal filter embolic protection devices did not significantly impact ST-segment resolution, ejection fraction, MBG-3, TIMI-3 blood flow, distal embolization, or no reflow versus a control. In RCTs, the use of distal filter embolic protection devices versus control did not significantly impact the risk of side branch occlusion. No coronary dissections and coronary perforations occurred in either group in the one trial reporting these outcomes. Use of a distal filter embolic protection device increased the procedure time versus a control in the one trial evaluating this outcome.

In RCTs in mixed or other ACS populations (NSTEMI or UA), the use of a distal filter embolic protection device did not impact the risk of 30-day mortality (one trial) or 180-day MACE (one trial), and there were insufficient data to analyze other final health outcomes. No additional trials or studies evaluated final health outcomes at additional time periods.