Document Detail


Clinical experience with a novel intracoronary perfusion catheter to treat no-reflow phenomenon in acute coronary syndromes.
MedLine Citation:
PMID:  20337859     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The no-reflow phenomenon is an often seen complication in patients presenting with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). This event is associated with poor prognosis and poses a therapeutic challenge. METHODS: This retrospective study cohort was composed of 30 patients who presented with ACS between September 2007 and April 2009, and developed no-reflow during subsequent PCI. The primary end-point was defined as normal Thrombolysis In Myocardial Infarction (TIMI) 3 flow with myocardial blush grade (MBG) >or=2 or an increase in TIMI flow by >or=2 grades with a MBG >or=2 after intracoronary drug infusion via the ClearWay (CW) RX perfusion catheter. RESULTS: The population presented with a relatively high prevalence of cardiovascular risk factors. ST-elevation myocardial infarction was the most common presentation (60.0%), while 20% of the patients presented with cardiogenic shock. After intracoronary infusion of nicardipine or nitroprusside using the CW catheter, TIMI flow improved from the baseline in 19 cases (63.3%, P < 0.001), and 16 patients (53.3%, P < 0.001) achieved normal coronary flow at the end of the procedure. The rate of in-hospital death was 6.7% (2 cases). No clinical differences were noted between those patients who successfully achieved normal coronary flow and those with persistent no-reflow. CONCLUSION: The infusion of intracoronary drugs using the novel perfusion CW RX catheter seems to be safe and could help to improve myocardial perfusion in a selected group of patients presenting with ACS who developed no-reflow during PCI.
Authors:
Gabriel Maluenda; Itsik Ben-Dor; Cedric Delhaye; Manuel A Gonzalez; Sara D Collins; Rebecca Torguson; Zhenyi Xue; William O Suddath; Lowell F Satler; Kenneth M Kent; Joseph Lindsay; Augusto D Pichard; Ron Waksman
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Publication Detail:
Type:  Journal Article     Date:  2010-03-12
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  23     ISSN:  1540-8183     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-05-14     Completed Date:  2010-08-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  109-13     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Division of Cardiology, Washington Hospital Center, Washington, DC 20010, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / mortality,  physiopathology*,  therapy*
Aged
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Catheterization*
Cohort Studies
Coronary Circulation* / drug effects
Female
Hospital Mortality
Humans
Male
Middle Aged
Nicardipine / administration & dosage
Nitroprusside / administration & dosage
Perfusion / instrumentation*
Retrospective Studies
Vasodilator Agents / administration & dosage
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 15078-28-1/Nitroprusside; 55985-32-5/Nicardipine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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