Results from the VAMPIRE 3 study suggest that selective use of distal filter protection may decrease the incidence of no-reflow phenomenon after percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) patients with attenuated plaque ≥5mm based upon intravascular imaging.

The study, presented at TCT 2017 in Denver, randomized 200 ACS patients from 13 sites in Japan to either distal filter protection or conventional treatment. Results showed the primary endpoint of no-reflow phenomenon occurred in 26.5 percent in the distal filter protection group (N=98) and 41.7 percent in the conventional group (N=96, P=0.0261).

Additionally, researchers noted the corrected TIMI frame count after revascularization was significantly lower in the distal filter protection group (23.0 vs. 30.5, P=0.0003), as was the incidence of in hospital adverse cardiac events (0 percent vs. 5.2 percent, P=0.028). As a result, distal protection during catheter intervention may facilitate procedural safety in patients with acute coronary syndrome.

"The selective use of embolic protection devices for patients at high risk for distal embolization is of great interest among interventional cardiologists," said Kiyoshi Hibi, MD, associate professor at Yokohama City University Medical Center in Japan. "VAMPIRE 3 shows that the use of distal embolic protection using a filter device decreased the incidence of no-reflow phenomenon with fewer serious adverse cardiac events after revascularization."

ACC.org Editor-in-Chief Kim Eagle, MD, FACC, cautions that larger, additional studies are needed before final conclusions are made.

Keywords: Plaque, Atherosclerotic, Plaque, Amyloid, TCT17, Transcatheter Cardiovascular Therapeutics

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