The MGuard coronary stent: safety, efficacy, and clinical utility

Figures & data

Figure 1 MGuard stent crimped onto a balloon.

Notes: Green arrow indicates the mesh sleeve. Red arrow indicates the metallic platform.

Figure 2 Coronary angiogram (30° cranial oblique projection) showing a totally occluded right coronary artery before intervention (A). Despite exhaustive thrombus aspiration. Red arrow points to the thrombotic total occlusion. (B), a high thrombus burden (TIMI thrombus score =4) persisted at the bifurcation (red arrows). After MGuard deployment (green line), TIMI 3 flow was restored to the posterolateral branch, although the posterior descending artery persisted totally occluded (C). Following “reverse T stenting,” final TIMI flow was 3 in both the posterior descending artery and the posterolateral branch branches (D, final result).

Abbreviation: TIMI, thrombolysis in myocardial infarction.

Table 1 Summary of studies with the MGuard stent in patients with STEMI

	n	Comparative treatment	Follow-up	ST-segment resolution	TIMI flow 3 achieved	Blush grade 3	Mortality 30 days/1 year	TLR 30 days/1 year	Stent thrombosis 30 days/1 year
Randomized trials
MASTER I^Citation12	433	BMS/DES	1 year	57.8 vs 44.7 P (0.008)	91.7 vs 82.9 P (0.006)	74.2 vs 72.1 P (NS)	0 vs 1.9 P (NS)/1 vs 3.3 P (NS)	1.8 vs 0.5 P (NS)/8.6 vs 0.9 P (0.0003)	1.4 vs 0.9 P (NS)/2.3 vs 0.9 P (NS)
MICAMI-MGUARD^Citation33	40	BMS	6 months	–	90 vs 80 P (NS)	90 vs 50 P (0.006)	0 vs 0/NA	0 vs 0/NA	0 vs 0
MASTER II^Citation14	310	BMS/DES	30 days	56.9 vs 59.3 P (NS)	91.4 vs 89 P (NS)	–	0.6 vs 1.9 P (NS)/NA	2.6 vs 2.6 P (NS)/NA	2.6 vs 3.2 P (NS)/NA
MASTER I + II^Citation14 (pooled analysis)	743	BMS/DES	30 days	57.5 vs 50.7 P (NS)	91.6 vs 85.4 P (0.008)	–	0.3 vs 1.9 P (0.04)/NA	2.2 vs 1.3 P (NS)/NA	1.9 vs 1.9 P (NS)/NA
Nonrandomized
aPiscione et al^Citation15	100	–	24 months	90	2.85 (mean)	90	2.3/2.2b	–/3.4b	2.3/1.1b
MAGICAL^Citation16	60	–	36 months	61.4	90	73	0/7c	0/1.8c	0/0c
Romaguera et al^Citation13	56	–	9 months	58.7	82.3	55.4	0d	1.8d	1.8d
REWARD-MI^Citation18	158e	BMS	10 months	–	97.5 vs 94.9 P (NS)	–	NA/6.3 vs 6.3 P (NS)	NA/11.4 vs 1.3 P (0.009)	NA/2.4 vs 1.3 P (NS)
iMOS registry^Citation19 (STEMI only)	268	–	12 months	86	94	74	–	–	–

Notes: Values expressed as %.

a Excluding 16 cardiogenic shock patients, in whom five events of in-hospital deaths occurred;

b at 24 months;

c at 36 months;

d at 9 months;

e matched group.

Abbreviations: BMS, bare metal stent; DES, drug-eluting stent; NA, not available; NS, not significant; STEMI, ST-segment elevation myocardial infarction; TLR, target lesión revascularization; TIMI, thrombolysis in myocardial infarction.

StoneGWAbizaidASilberSProspective, randomized, multicenter evaluation of a polyethylene terephthalate micronet mesh-covered stent (MGuard) in ST-segment elevation myocardial infarction: the MASTER trialJ Am Coll Cardiol Epub2012928

 Google Scholar

LindefjeldDSGuardaEMéndezMMicrovascular coronary flow comparison in acute myocardial infarction angioplasty treated with a mesh covered stent (MGUARD stent) versus bare metal stent: MICAMI-MGUARDCardiovasc Revasc Med20131414823337378

 PubMedGoogle Scholar

StoneGWThe MASTER II trial. Comparison of the MGuard embolic protection stent with standard stent in acute myocardial infarctionPresented at: The International Conference for Innovations MeetingDecember; 2014Tel Aviv, Israel

 Google Scholar

PiscioneFDanziGBCasseseSMulticentre experience with MGuard net protective stent in ST-elevation myocardial infarction: safety, feasibility, and impact on myocardial reperfusionCatheter Cardiovasc Interv201075571572119937780

 PubMed Web of Science ®Google Scholar

DudekDDziewierzARzeszutkoLMesh covered stent in ST-segment elevation myocardial infarctionEuroIntervention20106558258921044911

 PubMed Web of Science ®Google Scholar

RomagueraRGomez-HospitalJASanchez-ElviraGMGuard mesh-covered stent for treatment of ST-segment elevation myocardial infarction with high thrombus burden despite manual aspirationJ Interv Cardiol20132611723419104

 PubMed Web of Science ®Google Scholar

Fernandez-CisnalACid-AlvarezBAlvarez-AlvarezBReal world comparison of the MGuard Stent versus the bare metal stent for ST elevation myocardial infarction (the REWARD-MI study)Catheter Cardiovasc Interv2015851E1E924905554

 PubMed Web of Science ®Google Scholar

AmorosoGVosNSVan der HeydenJAA prospective, post-market study with the Mguard Prime Embolic Protection Stent in ST-segment elevation myocardial infarction: The International MGuard Prime Observational Study (IMOS Prime)Catheter Cardiovasc Interv Epub201537

 Web of Science ®Google Scholar