Document Detail


Feasibility of primary clot extraction prior to percutaneous coronary intervention in acute myocardial infarction.
MedLine Citation:
PMID:  18383164     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Raed Aqel; Gilbert Zoghbi; Fadi Hage; George Philips; Gilbert Perry; Ami Iskandrian; Louis Dell'Italia
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
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:
Created Date:  2008-05-29     Completed Date:  2008-06-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  870-6     Citation Subset:  IM    
Copyright Information:
2008 Wiley-Liss, Inc.
Affiliation:
VA Tertiary Hospital/Birmingham, University of Alabama at Birmingham, USA. raed.aqel@va.gov
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MeSH Terms
Descriptor/Qualifier:
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:
Catheter Cardiovasc Interv. 2008 Jun 1;71(7):877-8   [PMID:  18498139 ]

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


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