Reduction of ischemia with a new flow-adjustable hemoperfusion pump during coronary angioplasty
| Autor: | Michael J. Cowley, Germano DiSciascio, Larry S. Dean, Michael G. Vandormael, Jeffrey A. Brinker, Paolo Angelini, John S. Douglas |
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| Rok vydání: | 1992 |
| Předmět: |
Coronary Vein
medicine.medical_specialty business.industry medicine.medical_treatment Femoral artery Anterior Descending Coronary Artery Chest pain medicine.disease Angina Angioplasty Internal medicine Right coronary artery medicine.artery medicine Cardiology Myocardial infarction medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American College of Cardiology. 19:657-662 |
| ISSN: | 0735-1097 |
| Popis: | A new flow-adjustable pump for coronary hemoperfusion to prevent ischemia during routine coronary angioplasty was evaluated in a multicenter prospective study of 110 patients. The protocol included patients who had angina or ST segment elevation during a control balloon inflation of ≤3 min. Hemoperfusion was performed by means of a new large lumen angioplasty catheter utilizing the patient's renal vein or femoral artery blood. Vessels perfused were the left anterior descending coronary artery (n = 74), right coronary artery (n = 39), left circumflex artery (n = 9) and coronary vein grafts (n = IS).Mean (± SD) perfusion flow was 41 ± 9 ml/min (range 17 to 70); mean perfusion time was 9.3 ± 4 min (median 8.5, range 2 to 30). Chest pain score (0 to 4) decreased from 2.9 ± 1 to 1.4 ± 1 during hemoperfusion (p < 0.001); ST segment elevation score (0 to 4) decreased from 2.6 ± 1 to 0.7 ± 1 (p < 0.005) and inflation time increased from 1.3 ± 0.9 to 7 ± 4 min, (p < 0.001). At least a 50% increase in tolerated inflation time was obtained in 104 patients (95%). Free plasma hemoglobin and creatine kinase levels did not increase significantly over baseline values.Angioplasty was successful in 107 patients (97%), with mean stenosis reduced from 87 ± 11% to 20 ± 17%; 3 patients had urgent bypass surgery, 2 (1.8%) had a myocardial infarction (1Q wave, 1 non-Q wave) and 2 (1.8%) died later in the hospital of probable noncoronary causes. Complications related to hemoperfusion were transient heart block during dilation of the right coronary artery in two patients and hematoma requiring transfusion in five (4.5%).Thus, this initial feasibility study indicates that this new hemoperfusion system is safe and effective in ameliorating ischemia and allowing longer balloon inflations during coronary angioplasty. |
| Databáze: | OpenAIRE |
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