Author + information
- Abhilash Akinapelli,
- Muhammad S. Azzouz,
- Michael D. White and
- Michael Del Core
Embolic protection devices (EPD) have been shown to be effective in reducing major adverse cardiovascular events (MACE) after saphenous vein graft (SVG) intervention and recommended by current guidelines. However, the necessity of the EDPs have been questioned in recent retrospective studies. Due to this equipoise, we performed systematic review and meta-analysis of studies evaluating the efficacy of EDPs.
PubMed and Cochrane databases were queried electronically to identify studies evaluating the efficacy of EPDs during SVG intervention. Analysis was performed following the PRISMA guidelines using random effects model.
A total of 12 (3 randomized, 9 observational) studies with 72,883 (EPD group=15999, Control=56,884) patients met the inclusion criteria. 76% of the patients were male with an average age of 69 years. There was no statistically significant difference between the rate of death (Relative risk [RR] 0.91 with 95% CI 0.77-1.07), myocardial infarction (RR 0.92, CI 0.59-1.43) and no reflow phenomenon (RR 0.77, CI 0.39-1.52). There was a significant lower rate of MACE in EPD group (RR 0.66, CI 0.52-0.85). Sensitivity analysis based on follow up duration did not change the results.
EPDs during the SVG intervention did not reduce the mortality or recurrent myocardial infarction, but did decrease the total MACE secondary to a lower rate of target lesion revascularization.