Prophylactic use of manual thrombectomy in ST-segment elevation myocardial infarction
| Autor: | S. Hinan Ahmed, Bernard Abi-Saleh, Peyman Soltani, Nadeem M. Husain, Malik Taimur Ali, S. Khawaja |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Suction Coronary Angiography Severity of Illness Index Coronary circulation medicine.artery Angioplasty Internal medicine Coronary Circulation medicine Humans cardiovascular diseases Myocardial infarction Prospective Studies Thrombus Angioplasty Balloon Coronary Aged Thrombectomy business.industry Coronary Thrombosis Percutaneous coronary intervention General Medicine Middle Aged medicine.disease Combined Modality Therapy Surgery medicine.anatomical_structure Treatment Outcome Right coronary artery Conventional PCI Cardiology Female Cardiology and Cardiovascular Medicine business TIMI |
| Zdroj: | Cardiovascular revascularization medicine : including molecular interventions. 10(4) |
| ISSN: | 1878-0938 |
| Popis: | Objective We sought to evaluate the effects of manual thrombectomy on myocardial reperfusion performed during percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Background Complete reperfusion after primary PCI is compromised by the presence of intraluminal thrombus. Thus effective and safe extraction of thrombus in a timely fashion is important for successful reperfusion. Methods Thirty-two patients (age 51±12 years, males 78%) with STEMI and angiographic evidence of intraluminal thrombus underwent thrombectomy during an 18-month period. Thrombectomy was performed after the presence of thrombus was confirmed angiographically by the operator either before or after primary angioplasty. Thrombectomy was performed using the 6F Export Aspiration Catheter (Medtronic Corporation, Santa Rosa, CA, USA). Myocardial reperfusion using Thrombolysis in Myocardial Infarction (TIMI) flow and myocardial blush grade was assessed by two independent observers. Results The infarct-related artery was left anterior descending (59%), right coronary artery (19%), saphenous venous graft (19%), or left circumflex artery (3%). The coronary lesion was Type B in 62% and Type C in 37% patients, with an average length of 18.2 + 4.6 mm and reference vessel diameter of 3.2±0.4 mm. The preprocedural TIMI flow was 0 in 62%, 1 in 12%, 2 in 22%, and 3 in 3% of patients. The postprocedural TIMI flow was 0 in 3%, 1 in 6%, 2 in 25%, and 3 in 56% of patients. The postprocedural myocardial blush grade was 0 in 6%, 1 in 9%, 2 in 35%, and 3 in 48% of patients. The in-hospital mortality was 0 and the 30-day mortality was 3%. Conclusion Manual thrombectomy using an Export catheter is safe and effective in establishing myocardial reperfusion after STEMI. |
| Databáze: | OpenAIRE |
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