News | Embolic Protection Devices | October 31, 2017

Distal Filter Embolic Protection Decreases No-reflow Phenomenon in ACS Patients With Attenuated Plaque

Primary endpoint occurred in more than 25 percent of DP patients versus more than 40 percent of patients randomized to conventional treatment

The Boston Scientific FilterWire EZ embolic protec filter system.

The Boston Scientific FilterWire EZ embolic protection system.

October 31, 2017 — The VAMPIRE 3 study evaluated if the selective use of distal filter protection might decrease the incidence of no-reflow phenomenon after percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) patients with attenuated plaque ≥5mm based upon intravascular imaging. It also examined its long-term effects.

Researchers enrolled 200 ACS patients who had a native coronary artery lesion and attenuated plaque with a longitudinal length of ≥5mm by pre-PCI IVUS. They were randomized to distal filter protection (DP) or conventional treatment (CT).

The primary endpoint of no-reflow phenomenon occurred in 26.5 percent in the DP group (N=98) and 41.7 percent in the CT group (N=96, P=0.0261) and the corrected TIMI frame count after revascularization was significantly lower in the DP group (23 vs. 30.5, P=0.0003). In addition, the incidence of in hospital adverse cardiac events was significantly lower in the DP group than in the CT group (0 percent vs. 5.2 percent, P=0.028).

“The selective use of embolic protection devices for patients at high risk for distal embolization is of great interest among interventional cardiologists,” said Kiyoshi Hibi, M.D., associate professor at Yokohama City University Medical Center in Yokohama, Japan. “VAMPIRE 3 shows that the use of distal embolic protection using a filter device decreased the incidence of no-reflow phenomenon with fewer serious adverse cardiac events after revascularization.”

The VAMPIRE 3 study was funded by Boston Scientific Corp., Nipro and Japan Lifeline. Hibi reported no disclosures.

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