MGuard Stent in ST-elevation Myocardial Infarction

NCT ID: NCT01124942

Last Updated: 2022-03-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

350 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-03-01

Study Completion Date

2013-03-01

Brief Summary

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The Investigators will test the hypothesis that MGuard net protective stent, the investigational device, would be superior to conventional revascularization strategy (i.e. bare-metal stenting plus manual thrombectomy), for STEMI patients undergoing urgent percutaneous coronary interventions.

Detailed Description

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Embolization of thrombotic debris still represents a complication for ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary interventions (PCI).

Distal embolization may decrease coronary and myocardial reperfusion after PCI in STEMI setting.

Unfortunately, intracoronary filters present several important limitations limiting their use and their efficacy especially in presence of huge amount of thrombus. In this respect, recent trials investigated whether a default manual thrombectomy strategy before stenting would ameliorate angiographic as well as clinical outcomes for STEMI patients undergoing percutaneous revascularization.

Of note, the most of embolization occurs when guidewire, and thrombectomy device cross the thrombus, and after the stent has been implanted as a consequence of plaque prolapse through the stent struts.

MGuard net protective stent, the investigational device, is a bare-metal stent covered with a ultra-thin flexible polyethylene terephthalate (or Dacron) mesh sleeve, that is anchored to the external surface of the struts. This biocompatible fiber net (string diameter 10-22 μm) has minimal effects on the stents' trackability and deliverability. During stent deployment, the net stretches and slides over the expanding stent struts, trapping the thromboembolic debris underneath the fiber net and isolating the prothrombotic intima components from the blood stream.

This protocol will test the hypothesis that MGuard stent would be superior to conventional revascularization strategy (i.e. bare-metal stenting plus manual thrombectomy), for STEMI patients undergoing urgent PCI in terms of angiographic as well as clinical outcomes.

Conditions

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ST-elevation Myocardial Infarction Thrombus Stents

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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MGuard

MGuard net protective stent, investigational device

Group Type EXPERIMENTAL

MGuard net protective coronary stent

Intervention Type DEVICE

It is a new closed-cell design stent concept. with an ultra-thin flexible polyethylene terephthalate (or Dacron) mesh sleeve, anchored to the external surface of the struts. This net (string diameter 10-22 μm) minimally affects stents' trackability and deliverability. During stent deployment, the net stretches and slides over the expanding stent struts, trapping the thromboembolic debris underneath the fiber net.

BMS plus thrombectomy

Bare-metal stent plus manual thrombectomy device

Group Type ACTIVE_COMPARATOR

Bare-metal stent and manual thrombectomy device

Intervention Type DEVICE

Manual thrombectomy device as an adjunctive strategy for conventional stenting with a bare-metal stent

Interventions

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MGuard net protective coronary stent

It is a new closed-cell design stent concept. with an ultra-thin flexible polyethylene terephthalate (or Dacron) mesh sleeve, anchored to the external surface of the struts. This net (string diameter 10-22 μm) minimally affects stents' trackability and deliverability. During stent deployment, the net stretches and slides over the expanding stent struts, trapping the thromboembolic debris underneath the fiber net.

Intervention Type DEVICE

Bare-metal stent and manual thrombectomy device

Manual thrombectomy device as an adjunctive strategy for conventional stenting with a bare-metal stent

Intervention Type DEVICE

Other Intervention Names

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MGuard net protective stent

Eligibility Criteria

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Inclusion Criteria

* \>/= 18-year-old patients, willing to participate the study, after informed consent signature
* Female not pregnant or potentially child-bearing
* \> 1 mV ST segment elevation in two or more contiguous leads
* Acute MI lasting more than 30 minutes and less than 12 hours
* De novo acute MI
* Infarct related artery reference vessel diameter \>/= 2.5 mm
* Patient suitable for stenting according to vessel and lesion features

Exclusion Criteria

* Dual antiplatelet therapy contraindication
* Ischemic stroke less than 30 days or previous haemorrhagic stroke
* WBC count less than 1000 per mm3;
* Platelet count less than 50.000 per mm3
* Life expectancy less than 1 year
* Cardiogenic shock at admission
* Previous stented infarct related artery
* Stent thrombosis as the responsible for current STEMI
* Inability to identify infarct related artery
* True bifurcation lesion, or lesion near a side branch with a reference vessel diameter \>/= 2.5 mm that could be diseased after stenting procedure
* LBBB
* Definitive pacing (or ECG abnormalities precluding ST-segment resolution evaluation
* Participation other study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Federico II University

OTHER

Sponsor Role lead

Responsible Party

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Giovanni Esposito

Cardiologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Federico Piscione, Associate Professor

Role: STUDY_CHAIR

Federico II University of Naples

Locations

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Federico II University of Naples

Naples, , Italy

Site Status

Countries

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Italy

References

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Piscione F, Danzi GB, Cassese S, Esposito G, Cirillo P, Galasso G, Rapacciuolo A, Leosco D, Briguori C, Varbella F, Tuccillo B, Chiariello M. Multicentre experience with MGuard net protective stent in ST-elevation myocardial infarction: safety, feasibility, and impact on myocardial reperfusion. Catheter Cardiovasc Interv. 2010 Apr 1;75(5):715-21. doi: 10.1002/ccd.22292.

Reference Type BACKGROUND
PMID: 19937780 (View on PubMed)

Rapacciuolo A, D'andrea C, Maresca G, di Pietro E, Piscione F, Chiariello M. Multiple MGuard stent implantation to treat massive right coronary artery dissection during primary coronary angioplasty. J Cardiovasc Med (Hagerstown). 2011 May;12(5):356-60. doi: 10.2459/JCM.0b013e328334092d.

Reference Type BACKGROUND
PMID: 20093945 (View on PubMed)

Other Identifiers

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NA116/09

Identifier Type: -

Identifier Source: org_study_id

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