Document Detail

Detection of embolic particles with the Doppler guide wire during coronary intervention in patients with acute myocardial infarction: efficacy of distal protection device.
MedLine Citation:
PMID:  15653017     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We investigated whether embolic particles could be detected as high-intensity transient signals (HITS) with a Doppler guide wire during percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) We also assessed whether these signals could be reduced using a distal protection (DP) device. BACKGROUND: Embolization of thrombi and plaque components to the microcirculation is a major complication of PCI in patients with AMI. Embolic particles running in the cerebral artery are detected as HITS by transcranial Doppler ultrasound. METHODS: We prospectively studied 16 consecutive patients with AMI who underwent direct PCI within 24 h after the onset of symptoms. A PercuSurge GuardWire (MedtronicAVE, Santa Rosa, California) was used as the DP device. Eight patients were randomly assigned to the non-DP group, and the remaining eight were assigned to the DP group. Coronary flow velocity was recorded continuously from before the first balloon inflation to after balloon deflation. RESULTS: All patients in the non-DP group had HITS detected (12 +/- 9 counts) within five consecutive beats (4 +/- 1 beat) after balloon deflation, but none were detected in any of the patients in the DP group. CONCLUSIONS: The Doppler guide wire can be used to visually detect and count emboli as HITS, and the DP device is effective for prevention of distal embolization.
Atsunori Okamura; Hiroshi Ito; Katsuomi Iwakura; Shigeo Kawano; Koichi Inoue; Yoshihiro Maekawa; Toshio Ogihara; Kenshi Fujii
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  45     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-17     Completed Date:  2005-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  212-5     Citation Subset:  AIM; IM    
Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka 530-0001, Japan.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*,  instrumentation*
Blood Flow Velocity
Coronary Circulation
Embolism / etiology,  prevention & control*,  ultrasonography*
Heart Catheterization
Middle Aged
Myocardial Infarction / therapy*
Prospective Studies
Ultrasonography, Doppler, Duplex
Ultrasonography, Interventional*

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