| Adjunctive thrombectomy with primary percutaneous coronary intervention for ST-elevation myocardial infarction: summary of randomized trials. | |
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MedLine Citation:
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PMID: 16883029 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) achieves brisk coronary flow in > 90% of patients, but myocardial reperfusion (reperfusion at the tissue level) is often suboptimal, as evidenced by persistent ST-segment elevation and abnormal myocardial blush. Patients with suboptimal myocardial reperfusion have limited myocardial salvage and increased mortality. Distal micro-embolization may contribute to poor myocardial reperfusion, and this has stimulated great interest in the use of adjunctive thrombectomy with primary PCI in an attempt to prevent distal micro-embolization and improve outcomes. In this paper, we review the randomized trials that have evaluated the use of adjunctive thrombectomy with primary PCI using three types of devices (X-sizer, aspiration thrombectomy and rheolytic thrombectomy). The results of these trials have been conflicting and the totality of evidence does not support the routine use of thrombectomy for removal of thrombus in patients with STEMI treated with primary PCI. In patients with large thrombus burden, distal macroembolization is common and is associated with poor outcomes. Adjunctive thrombectomy can effectively remove thrombus, and it seems appropriate to perform adjunctive thrombectomy prior to primary PCI in patients with large thrombus burden. |
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Authors:
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Bruce R Brodie |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: The Journal of invasive cardiology Volume: 18 Suppl C ISSN: 1557-2501 ISO Abbreviation: J Invasive Cardiol Publication Date: 2006 Jul |
Date Detail:
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Created Date: 2006-08-02 Completed Date: 2007-09-18 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8917477 Medline TA: J Invasive Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: C24-7 Citation Subset: IM |
Affiliation:
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Moses Cone Heart and Vascular Center, LeBauer Cardiovascular Research Foundation, Greensboro, North Carolina, USA. bbrodie@triad.rr.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary* Coronary Thrombosis / complications*, therapy* Electrocardiography* Heart Catheterization Humans Myocardial Infarction / complications*, physiopathology, therapy* Randomized Controlled Trials as Topic Suction Thrombectomy* / methods |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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