| Intracoronary thrombectomy with the export aspiration catheter before angioplasty in patients with ST-segment elevation myocardial infarction. | |
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MedLine Citation:
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PMID: 17391222 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We aimed to assess the safety and feasibility of thrombectomy with the Export Aspiration Catheter (EAC) before angioplasty, and its ability to improve angiographic results in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Distal embolization of atherothrombotic material often occurs during angioplasty in STEMI, compromising optimal myocardial reperfusion. METHODS: We performed a thrombus-aspiration with EAC prior to angioplasty in 64 consecutive patients with STEMI. Successful thrombectomy was defined as an improvement of TIMI flow grade >or=1. RESULTS: Successful thrombectomy (increase of TIMI flow >or=1) was achieved in 40 patients (62.5%). Mean TIMI flow grade increased from 0.7 +/- 1 to 1.9 +/- 1.2 (p < 0.0001) after thrombectomy. TIMI flow grade 3 was observed more frequently after EAC compared with guidewire alone (51.5% vs. 9%, p = 0.0062). Direct stenting was performed in most of the patients (n = 41, 64%). Distal embolization and no reflow/slow flow phenomenon occurred in 8 patients (12.5%). No vessel injury after EAC thrombectomy was reported. After treatment with balloon angioplasty and/or stenting, final TIMI flow grade 3 was achieved in 54 patients (84.5%). By multivariate analysis, ischemic time < 6 hours was a significant independent predictor of successful thrombectomy (p = 0.0437). CONCLUSIONS: Our series suggests that EAC thrombectomy prior to angioplasty in the setting of STEMI is safe and feasible. It might reduce the culprit coronary lesion's thrombus burden, leading to improved flow restoration and myocardial reperfusion. Further large randomized studies are warranted to confirm these preliminary results and to assess the impact of thrombus-aspiration on infarct size as well as on clinical outcomes. |
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Authors:
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Rémy Cohen; Thierry Domniez; Rémi Foucher; Anis Sfaxi; Simon Elhadad |
Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Journal of interventional cardiology Volume: 20 ISSN: 0896-4327 ISO Abbreviation: J Interv Cardiol Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-03-29 Completed Date: 2007-06-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8907826 Medline TA: J Interv Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 136-42 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Centre Hospitalier Lagny-Marne-la-Vallée, Lagny-sur-Marne, France. remycohen@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Aged Angioplasty, Transluminal, Percutaneous Coronary* Catheterization / instrumentation* Coronary Angiography Feasibility Studies Female Humans Male Middle Aged Myocardial Infarction / therapy* Preoperative Care Prospective Studies Safety Thrombectomy / instrumentation, methods* Time Factors Treatment Outcome* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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