Distal Embolization: A Threat to the Coronary Artery?

A67-year-old man with a history of hypertension and hypercholesterolemia was scheduled for elective direct stent implantation for a severe proximal left descending artery stenosis. Using the femoral approach, a 7-French Judkins left guiding catheter was placed in the left coronary ostium. To keep the activated clotting time >300 s, 10 000 IU of heparin and 250 mg of aspirin were given intravenously. After introducing an intermediate guide wire (Guidant Inc), we placed an AngioguardTM (Angioguard Inc) distal to the target lesion. This guidewire-based, filter-type device captures embolic debris while maintaining distal perfusion by means of an expandable umbrella. Successful direct stenting was performed with an Tristar 3.5/18-mm premounted stent (Guidant Inc) at an inflation pressure of 18 atm.

• View at Pubmed