The State of Coronary Thrombus Aspiration

Pruthi, Sonal; Bangalore, Sripal

doi:10.1161/jaha.122.026849

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…We have used thrombectomy catheters in 3.71% of patients with heavy clot burden as a bailout procedure. Studies have shown the use of thrombus aspiration up to 29% as a bailout procedure leading to more successful PCIs [15]. The less use of thrombectomy catheters is due to the non-availability of the advanced instruments in our setup.…”

Section: Discussionmentioning

confidence: 99%

Experience and Outcomes of Primary Percutaneous Coronary Intervention in a Tertiary Care Hospital in South Punjab, Pakistan

Akhtar,

Saleemi,

Zarlish

et al. 2023

Cureus

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Background: Primary percutaneous coronary intervention (PCI) is the emergency procedure and gold standard for the treatment of ST-Elevation Myocardial Infarction (STEMI).Objective: To share the experience and outcomes of primary PCI in a tertiary care hospital in South Punjab, Pakistan.Methods: A descriptive cross-sectional study was planned from the 1 st of April, 2023 to the 30 th of September, 2023. All patients presenting with acute STEMI undergoing primary PCI were included in the study. Data regarding patient demographics, risk factors, procedural characteristics, time variables, and inhospital events was observed.Results: A total of 1132 patients were included in the study. There were 934 (82.5%) males. Smoking is the most common risk factor among all the patients. Anterior wall myocardial infarction is the most common STEMI and the left anterior descending artery is the culprit vessel in 58.3% (n=660) of patients. Single vessel disease was present in 34.6% (n=392) of the patients. Thrombolysis in Myocardial Infarction (TIMI )Flow III was achieved in 80% (n=906) of patients after primary PCI. The average total ischemic time of the patients included in the study was 5 hours and 48 minutes, with a standard deviation of 3 hours and 55 minutes. Our mortality was 3.5% (n=40). Conclusion: Our patients take a longer time to present to the PCI-capable centers. Despite their late presentation, primary PCI has better outcomes for treating acute STEMI.

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Section: Discussionmentioning

confidence: 99%

Experience and Outcomes of Primary Percutaneous Coronary Intervention in a Tertiary Care Hospital in South Punjab, Pakistan

Akhtar,

Saleemi,

Zarlish

et al. 2023

Cureus

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“…23 Compared with manual aspiration, continuous negative suction minimizes embolization of clots, which has been shown to reduce ischemic stroke in coronary intervention. 24 Continuous aspiration has been the standard of care compared with manual aspiration in both venous and arterial settings. 23 24 25 26 27 However, no randomized controlled studies have shown its efficacy and safety, speciﬁcally in PE.…”

Section: Penumbra Aspiration Thrombectomy Systemmentioning

confidence: 99%

“…24 Continuous aspiration has been the standard of care compared with manual aspiration in both venous and arterial settings. 23 24 25 26 27 However, no randomized controlled studies have shown its efficacy and safety, speciﬁcally in PE. CHEETAH study used the continuous aspiration system for arterial clots; however, it was studied in ACS, not PE.…”

Section: Penumbra Aspiration Thrombectomy Systemmentioning

confidence: 99%

Contemporary Management of Pulmonary Embolism: Review of the Inferior Vena Cava ﬁlter and Other Endovascular Devices

Lei,

DiCaro,

Tak

et al. 2024

Int J Angiol

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Inferior vena cava (IVC) filters and endovascular devices are used to mitigate the risk of pulmonary embolism in patients presenting with lower extremity venous thromboembolism in whom long-term anticoagulation is not a good option. However, the efficacy and beneﬁt of these devices remain uncertain, and controversies exist. This review focuses on the current use of IVC ﬁlters and other endovascular therapies in clinical practice. The indications, risks, and beneﬁts are discussed based on current data. Further research and randomized controlled trials are needed to characterize the patient population that would beneﬁt most from these interventional therapies.

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Subacute saphenous vein graft stent thrombosis due to unusual drug interaction: a case report

Koliastasis,

de Hemptinne,

Severin

et al. 2023

European Heart Journal - Case Reports

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Background Stent thrombosis is a potentially lethal complication of coronary angioplasty and responsible for 20% of all post-angioplasty myocardial infarctions. Unusual causes may be overlooked and difficult to identify. Case Summary A 70-year-old male with history of triple aortocoronary bypass presented with acute inferolateral ST-segment elevation myocardial infarction (STEMI). Critical stenosis of the vein graft to the right coronary artery was revealed and with use of distal embolic protection device, successful angioplasty with stent was performed under double antiplatelet treatment with aspirin and ticagrelor. 2 weeks later he presented again at the emergency department with an acute inferolateral STEMI. Subacute stent thrombosis with complete occlusion of the stented vein graft was evident. Repeated balloon dilatations restored the flow stabilizing the patient; optical coherence tomography showed good stent expansion and apposition. Scrutinizing the patient’s history, we discovered comedication with carbamazepine that is a CYP3A4 inducer and reduces ticagrelor’s effect. Switching to prasugrel ensured potent antiplatelet treatment and the patient was discharged 5 days later. 6 months follow-up was uneventful and free of symptoms. Discussion Stent thrombosis has dire consequences and the precipitating factors should always be investigated. Inadequate platelet inhibition secondary to non-compliance to therapy or resistance and suboptimal stent expansion/apposition are its main causes. Drug interactions are an underrecognized factor that may significantly alter the potency of antiplatelet drugs and also lead to stent thrombosis; thus, treatment is essential to be tailored to each patient comedication.

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The State of Coronary Thrombus Aspiration

Cited by 6 publications

References 15 publications

Experience and Outcomes of Primary Percutaneous Coronary Intervention in a Tertiary Care Hospital in South Punjab, Pakistan

Experience and Outcomes of Primary Percutaneous Coronary Intervention in a Tertiary Care Hospital in South Punjab, Pakistan

Contemporary Management of Pulmonary Embolism: Review of the Inferior Vena Cava ﬁlter and Other Endovascular Devices

Subacute saphenous vein graft stent thrombosis due to unusual drug interaction: a case report

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