Key result
Micro-net mesh stents reduce post-PCI IMR ~42% vs conventional DES in high thrombus burden.
Why the study?
Highly thrombotic coronary lesions remain a serious clinical challenge not effectively addressed by current technology, prompting evaluation of whether a micro-net mesh covering stent preserves post-PCI microcirculatory resistance.
Does PCI with a micro-net mesh covering stent improve the index of microcirculatory resistance in patients with NSTEMI or STEMI and high thrombus burden?
RCT (n=52)
Does PCI with a micro-net mesh covering stent improve the index of microcirculatory resistance in patients with NSTEMI or STEMI and high thrombus burden?
Absolute Event Rate: 33.2% vs 57.2%
p-value: p=0.005
In patients with acute coronary syndrome and high thrombus burden, a micro-net mesh covering stent significantly improved coronary microvascular dysfunction compared to conventional DES.
Supports micro-net mesh stents to protect microcirculation in high-thrombus ACS PCI; extends randomized stent comparisons to IMR endpoints.
BACKGROUND: Highly thrombotic coronary lesions continue to be a serious and clinically significant problem that is not effectively and completely addressed by current technology. OBJECTIVES: We aimed to investigate whether a micro-net mesh (MNM) technology covering stent could preserve the index of microcirculatory resistance (IMR) after percutaneous coronary intervention (PCI) in patients with high thrombus burden. METHODS AND RESULTS: Fifty-two patients with non-ST elevation myocardial infarction or ST Elevation Myocardial Infarction and high thrombus burden (TIMI thrombus grade ≥ 3) were randomized into two groups, PCI with a MNM covering stent (MNM group, n = 25) and PCI with any commercially available stent (DES group, n = 27). As the primary endpoint, IMR was measured immediately after PCI using a pressure-temperature sensor-tipped coronary wire. The secondary endpoint was left ventricular ejection fraction (LVEF) at 6 months of follow-up. The IMR in the MNM group was significantly lower in comparison to the DES group (33.2 [21.3, 48.9] vs. 57.2 [39.9, 98.0], p = 0.005). No significant differences were observed in baseline LVEF (54.5 ± 10.2% vs. 53.1 ± 6.87%, p = .57), while LVEF was significantly improved at follow-up in the MNM group (61.1 ± 7.1% vs. 53.9 ± 6.35%, p = .0001). CONCLUSION: MNM technology significantly improved coronary microvascular dysfunction after PCI in patient with acute coronary syndrome and appears as a useful technological option for thrombus management.
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Noirclerc et al. (2021) conducted an RCT in NSTEMI or STEMI with high thrombus burden (n=52). micro-net mesh (MNM) covering stent vs. commercially available stent (DES) was evaluated on index of microcirculatory resistance (IMR) measured immediately after PCI (p=0.005). A micro-net mesh covering stent significantly lowered the index of microcirculatory resistance immediately after PCI compared to conventional DES (33.2 vs. 57.2, p=0.005) in high thrombus burden.
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