AUTHOR=Yu Jianhong , Zhang Jianhai , Ni Jianchao , Shou Weiqing , Fang Yuanyuan , Fu Suna 

TITLE=Outcomes Following Percutaneous Coronary Intervention in Saphenous Vein Grafts With and Without Embolic Protection Devices: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.726579

DOI=10.3389/fcvm.2021.726579

ISSN=2297-055X

ABSTRACT=Objective: To review studies comparing outcomes following percutaneous coronary intervention (PCI) in saphenous vein grafts (SVG) with and without embolic protection devices (EPD).
Methods: Databases, including PubMed Central, Cochrane library, EMBASE, CINAHL, MEDLINE, Google Scholar, ScienceDirect, Scopus were searched from January 1964 until April 2021. We used the Cochrane risk of bias tool and Newcastle Ottawa scale to assess the quality of published studies based on study design. From the results, we carried out a meta-analysis with random-effects model and reported pooled odds ratio (OR) with 95% confidence interval (CI). 
Results: In total, 11 studies were analysed that included 79,009 total participants. EPD use had significantly lower odds of mortality (pooled OR=0.69; 95%CI: 0.50 to 0.94). However, there was no significant difference in terms of MACE (pooled OR=0.83; 95%CI: 0.67 to 1.03), target vessel revascularization (pooled OR=1.00; 95%CI: 0.95 to 1.05), periprocedural (pooled OR=1.12; 95%CI: 0.65 to 1.90) and late MI (pooled OR=0.79; 95%CI: 0.55 to 1.14) with or without EPD for PCI in SVG patients.
Conclusion: Although not statistically beneficial for MACE, target vessel revascularization, periprocedural and late MI, EPD use does appear to significantly reducing mortality for the patients undergoing PCI in SVG. Hence, clinicians might consider using EPD for such patients to reduce the burden of post-procedural morbidity and mortality.