Purpose: Treatment of aorto-coronary bypass grafts without a protection devices is associated with a high incidence of ischemic events. The Spider(R) system is a new protection device.
Methods And Results: We included 40 consecutive patients with 50 lesions and stenosis > 50% in bypass grafts. Follow-up was performed according to clinical records and by phone call after 30 days. Final TIMI flow 2 or 3 was observed in 97.5% of the patients, and no-reflow occurred in 10% without incidence of macroembolism. The technical success rate was 92.5%. A new rise of creatine kinase or troponin was observed in 27.5% after treatment, but 8 of 11 patients (72.7%) had only a periprocedural rise of troponin without elevation of creatine kinase. Debris was found in 52.5%, MACE rate was low (10%). Both types of stenoses (types A and B) were embolic, we found a trend for more frequent entrapped debris and periprocedural elevation of ischemic markers in type B stenoses, but these did not reach a significant level.
Conclusion: Using the Spider system is feasible, and offers a high technical success rate, no macroembolism, and excellent final TIMI flow, but the risk of microembolism and periprocedural myocardial infarction is not entirely eliminated.
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