| Use of an emboli containment and retrieval system during percutaneous coronary angioplasty in native coronary arteries. | |
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MedLine Citation:
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PMID: 11005103 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Prevention of distal embolisation during percutaneous coronary revascularisation may be necessary to reduce postinterventional morbidity and mortality. METHODS AND RESULTS: We employed a newly developed emboli containment and retrieval system in native coronary arteries during percutaneous coronary angioplasty and stenting in 39 selected patients (mean age 58.9 +/- 10.1 years, 11 females) presenting with acute (n = 22; 8 LAD, 3 LCX, 11 RCA), subacute (n = 7; 2 LAD, 2 LCX, 3 RCA) or chronic (n = 6; 2 LAD, 4 RCA) total or subtotal occlusion of an infarct-related vessel, or with severe stenosis and symptoms of unstable angina (n = 4; 2 LAD, 2 RCA). Protection device-assisted angioplasty with stent implantation was uneventful in all patients with good angiographic results and normal postprocedural flow. Intermittent aggravation of anginal pain during inflation of the occlusive balloon (from 2.5 to a maximum of 25 minutes cumulative inflation time) was observed in 19 of the 36 conscious patients (7 with acute, 7 with subacute and 3 with chronic occlusion, and 2 with unstable angina), but caused neither interruption of distal occlusion nor haemodynamic instability. In 31 patients the aspirates contained visible debris. Histological analysis showed particles up to 12 mm in size, consisting of necrotic core, inflammatory cells, cholesterol debris, and old and fresh thrombi. In 8 patients the aspirated particles were too small to allow microscopic diagnosis or debris was absent. CONCLUSIONS: This preliminary report demonstrates the feasibility of using a protection device in native coronary arteries to prevent distal embolisation of particulate matter that is mobilised during percutaneous interventions. To the extent that this material contributes to the mechanisms of distal embolisation, noreflow and infarction, this device may help to reduce such complications. Appropriately designed trials are required to assess the clinical benefit of this system. |
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Authors:
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G Sütsch; W Kiowski; A Bossard; T F Lüscher; W Maier; P Vogt; F W Amann |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Schweizerische medizinische Wochenschrift Volume: 130 ISSN: 0036-7672 ISO Abbreviation: Schweiz Med Wochenschr Publication Date: 2000 Aug |
Date Detail:
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Created Date: 2000-10-13 Completed Date: 2000-10-13 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0404401 Medline TA: Schweiz Med Wochenschr Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 1135-45 Citation Subset: IM |
Affiliation:
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Department of Medicine, University Hospital, Zurich. gabor.suetsch@dim.usz.ch |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angina Pectoris / physiopathology Angina, Unstable / physiopathology Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*, methods* Coronary Disease / pathology, therapy* Embolism / prevention & control* Female Humans Inflammation Male Middle Aged Myocardial Infarction / complications Necrosis Stents* / adverse effects |
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