Efficacy of Thrombosuction using the Export Aspiration Catheter before Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction

Kang, Woong Chol; Ahn, Tae Hoon; Han, Seung Hwan; Choi, Kyung Rim; Oh, Gyu Jin; Chung, Wook Jin; Shin, Mi Seung; Koh, Kwang Kon; Choi, In Suck; Shin, Eak Kyun

doi:10.4070/kcj.2005.35.2.172

Cited by 2 publications

(3 citation statements)

References 19 publications

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“…In this case, the patient was relatively stable and the occlusions were located at the distal portion of the coronary arteries, which were occupied with thrombus except for critical atherosclerotic stenosis, and he was successfully treated with thrombus aspiration and GP IIb/IIIa inhibitor. There were some reports that thrombus aspiration drew better reperfusion in patients in STEMI, 6) 7) and that this strategy was pro-bably helpful in a subset of patients with thrombotic occlusion of the distal coronary artery without critical atherosclerotic stenosis. In addition, anti-platelet therapy with GP IIb/IIIa inhibitor and heparin, during and after intervention, is very useful in such cases to prevent further thrombus formation and to salvage the myocardium.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Total Occlusion of Multiple Distal Coronary Arteries in Acute Myocardial Infarction

et al. 2011

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Simultaneous multiple coronary artery thrombosis is a rare finding in ST segment elevation myocardial infarction (STEMI). We report a case of myocardial infarction with multiple ST segment elevation on the electrocardiography and total occlusions of the distal left anterior descending artery (dLAD), as well as of the second and third obtuse marginal artery on emergency coronary angiography. Thrombus aspiration was performed at dLAD and systemic glycoprotein IIb/IIIa inhibitor was used successfully. In patients with STEMI, multiple coronary thromboses are unusual and associated with patient fatality. However, assertive thrombus aspiration and antiplatelet therapy could be effective in STEMI patients with multiple distal coronary artery occlusions.

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Section: Discussionmentioning

confidence: 99%

Simultaneous Total Occlusion of Multiple Distal Coronary Arteries in Acute Myocardial Infarction

et al. 2011

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“…Several randomized trials of patients with STEMI demonstrated that manual thrombus aspiration improved myocardial perfusion, when compared to conventional PCI 2)12). The role of AT has been particularly emphasized in patients with high-risk angiographic characteristics 13).…”

Section: Discussionmentioning

confidence: 99%

“…Several randomized trials of patients with STEMI demonstrated that manual thrombus aspiration improved myocardial perfusion, when compared to conventional PCI. 2) 12) The role of AT has been particularly emphasized in patients with high-risk angiographic characteristics. 13) Increased neutrophil count has been reported to be associated with increased risk of adverse clinical events and impaired microvascular perfusion in patients with acute myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

Effect of Aspiration Thrombectomy on Microvascular Dysfunction in ST-Segment Elevation Myocardial Infarction With an Elevated Neutrophil Count

Lee

Kim

et al. 2011

Korean Circ J

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Background and ObjectivesAspiration thrombectomy (AT) during primary percutaneous coronary intervention (PCI) is an effective adjunctive therapy for ST-segment elevation myocardial infarction (STEMI). An elevated neutrophil count in STEMI is associated with microvascular dysfunction and adverse outcomes. We evaluated whether AT can improve microvascular dysfunction in patients with STEMI and an elevated neutrophil count.Subjects and MethodsSeventy patients with STEMI undergoing primary PCI from August 2007 to February 2009 in our institution were classified by tertiles of neutrophil count on admission (<5,300/mm3, 5,300-7,600/mm3, and >7,600/mm3). The angiographic outcome was post-procedural thrombolysis in myocardial infarction (TIMI) flow grade. Microvascular dysfunction was assessed by TIMI myocardial perfusion (TMP) grade and ST-segment resolution on electrocardiography 90 minutes after PCI. The clinical outcome was major adverse cardiac event (MACE), defined as cardiac death, re-infarction, and target lesion revascularization at 9 months.ResultsThere were no significant differences in the clinical characteristics and pre- and post-procedural TIMI flow grades between the neutrophil tertiles. As the neutrophil count increased, a lower tendency toward TMP grade 3 (83% vs. 52% vs. 54%, p=0.06) and more persistent residual ST-segment elevation (>4 mm: 13% vs. 26% vs. 58%, p=0.005) was observed. The 9-month MACE rate was similar between the groups. On subgroup analysis of AT patients (n=52) classified by neutrophil tertiles, the same tendency toward less frequent TMP grade 3 (77% vs. 56% vs. 47%, p=0.06) and persistent residual ST-segment elevation (>4 mm: 12% vs. 28% vs. 53%, p=0.05) was observed as neutrophil count increased.ConclusionA higher neutrophil count at presentation in STEMI is associated with more severe microvascular dysfunction after primary PCI, which is not improved with AT.

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Efficacy of Thrombosuction using the Export Aspiration Catheter before Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction

Cited by 2 publications

References 19 publications

Simultaneous Total Occlusion of Multiple Distal Coronary Arteries in Acute Myocardial Infarction

Simultaneous Total Occlusion of Multiple Distal Coronary Arteries in Acute Myocardial Infarction

Effect of Aspiration Thrombectomy on Microvascular Dysfunction in ST-Segment Elevation Myocardial Infarction With an Elevated Neutrophil Count

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