Procedural efficacy and complications of X‐Sizer thrombectomy in de novo and stented lesions

Abstract

Angiographic thrombus is associated with poorer procedural and clinical outcomes. We report our experience with the X-Sizer thrombectomy device (EndiCOR Medical) from March 2001 to December 2002. Indications for use in 44 patients (33 male; mean age, 60) included myocardial infarction (27), unstable angina (6), periprocedural thrombosis (2), acute (< 24 hr) stent thrombosis (1), and subacute (> 24 hr) stent thrombosis (8). Three cases involved vein grafts. Deployment was successful in 42/44. Difficulty traversing the stent occurred in 5/9 cases of in-stent thrombosis. Median TIMI flow increased from 1 to 2 (P = 0.01) postthrombectomy. Median final TIMI flow was 3. Complications included dissection (1), perforation, device jam on stent (1), disruption of a covered stent (1), distal macro-embolization (4), and transient no-reflow (5). The X-Sizer thrombectomy device improves TIMI flow but does not always prevent distal embolization. Care is needed when treating in-stent thrombosis.

Intervencionismo en el contexto del infarto de miocardio. Conceptos actuales

“…A pesar de los importantes avances en el desarrollo de agentes antiplaquetarios y antitrombóticos, la persistencia de remanentes de trombo en las lesiones está fuertemente asociada con un alto riesgo de embolización distal y el fenómeno de no refujo, lo que conlleva resultados angiográficos y clínicos peores. Los abordajes mecánicos que se han desarrollado incluyen catéteres de aspiración del trombo, reolíticos, lisis por ultrasonido, dispositivos de protección distal y trombectomía mecánica 66 .…”