| Feasibility of primary clot extraction prior to percutaneous coronary intervention in acute myocardial infarction. | |
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MedLine Citation:
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PMID: 18383164 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To test the feasibility, safety, and in-hospital outcomes of utilizing the FilterWire EZ to extract clot prior to percutaneous coronary intervention (PCI) in patients presenting with acute myocardial infarction (MI). BACKGROUND: PCI in patients with acute MI is associated with a higher incidence of distal embolization, no-reflow, or slow flow partly due to the presence of clot burden. METHODS: The authors describe the feasibility, safety, and outcomes of using a FilterWire EZ distal protection device as a clot extraction device in patients who presented with acute MI and documented clot on coronary angiography. RESULTS: Fifteen consecutive male patients with a mean age of 54 +/- 8 years presented with acute MI (60% ST elevation MI). MI involved left anterior descending artery (n = 4), circumflex artery (n = 3), and right coronary artery (n = 8). Clot extraction followed by PCI reduced the percent diameter stenosis from 94 +/- 12 to 65 +/- 11 (P < 0.001) and restored TIMI 3 flow in all patients without distal embolization. The angiographic, procedural, and clinical success rates were 100%. The mean left ventricular ejection fraction (LVEF) was 52 +/- 8% (range 30-62%) with only three patients (15%) who had an LVEF <50% and five patients (33%) without apparent wall motion abnormalities on echocardiography. CONCLUSIONS: Clot extraction before PCI during acute MI in native coronaries is feasible, safe, and effective in restoring TIMI 3 flow without distal embolization. Whether this approach results in better outcomes and improved LV function compared with standard therapy alone requires further investigation. |
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Authors:
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Raed Aqel; Gilbert Zoghbi; Fadi Hage; George Philips; Gilbert Perry; Ami Iskandrian; Louis Dell'Italia |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 71 ISSN: 1522-726X ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-05-29 Completed Date: 2008-06-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 870-6 Citation Subset: IM |
Copyright Information:
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2008 Wiley-Liss, Inc. |
Affiliation:
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VA Tertiary Hospital/Birmingham, University of Alabama at Birmingham, USA. raed.aqel@va.gov |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary* Coronary Angiography Coronary Circulation Coronary Thrombosis / complications, physiopathology, radiography, surgery* Equipment Design Feasibility Studies Humans Male Middle Aged Myocardial Infarction / etiology, physiopathology, radiography, therapy* Severity of Illness Index Stroke Volume Thrombectomy* / adverse effects, instrumentation Treatment Outcome Ventricular Function, Left |
| Comments/Corrections | |
Comment In:
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Catheter Cardiovasc Interv. 2008 Jun 1;71(7):877-8
[PMID:
18498139
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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