Researchers at Thomas Jefferson University Hospital have shown that combining distal protection devices with the prophylactic use of the drug nicardipine is more effective at preventing life-threatening complications following a percutaneous coronary intervention (PCI) (angioplasty, stenting) on patients who have undergone previous bypass surgery than distal protection devices alone.
Their findings will be presented on Tuesday, October 23rd, at 8 a.m. at the Transcatheter Cardiovascular Therapeutics (TCT) conference, at the Miami Beach Convention Center by Michael P. Savage, MD, Director of the Cardiac Catheterization Lab at Jefferson.
Angioplasty or stenting on bypass vessels, called saphenous vein grafts, is associated with a high risk of complications due to distal embolization, the dislodging of plaque and clots downstream, impairing blood flow and leaving patients at-risk for a heart attack.
Distal protection devices are commonly used to prevent blockages by catching the dislodged plaque and clot in a basket-like device, allowing blood to filter through the bypassed artery. Still, complications remain in up to 10 percent of patients. Preliminary studies have suggested that prophylactic doses of the drug nicardipine, a common intracoronary vasodilator, can also help in this regard, but never have the two techniques been combined.
Savage and colleagues looked at clinical outcomes at 30 days post-PCI in 163 consecutive patients with prior bypass surgery. Group I consisted of 60 patients who underwent PCI using a distal protection device alone (no pre-treatment with nicardipine); Group II included 103 patients who underwent PCI with a distal protection device and pre-treatment with prophylactic nicardipine.