'Mother-in-child' thrombectomy technique: a novel and effective approach to decrease intracoronary thrombus burden in acute myocardial infarction. - 2013

Available in print through MWHC library: 2002 - present

BACKGROUND: The presence of large thrombus burden in patients presenting with acute myocardial infarction (AMI) is common and associated with poor prognosis. This study aimed to describe the feasibility and safety of the novel 'mother-in-child' thrombectomy (MCT) technique in patients presenting with AMI and large thrombus burden undergoing percutaneous coronary intervention (PCI). CONCLUSION: This initial report suggests that significant reduction in thrombus burden and improvement of the coronary flow can be safely achieved in patients presenting with AMI and large thrombus burden by using the novel MCT technique. Copyright 2013 Elsevier Inc. All rights reserved. METHODS: We studied 13 patients presenting with AMI who underwent PCI with persistent large intracoronary thrombus after standard thrombectomy. The procedure was performed using a 5F 'Heartrail II-ST01' catheter (Terumo Medical) into a 6F guiding system. Angiographic assessment of thrombus burden and coronary flow was obtained at baseline, immediately after thrombectomy and at the end of the procedure. RESULTS: The mean age was 55.9+/-13.0 years and involved mostly males (76.9%). All patients underwent PCI via radial approach. Following MCT Thrombolysis In Myocardial Infarction (TIMI) flow improved by 2 or more degrees in 11 patients (84.5%), while visible angiographic thrombus was reduced in 11 patients (84.5%). In the final angiogram, normal TIMI flow was restored in 11 patients (84.5%), with normal myocardial 'blush' in 7 patients (53.8%) and total clearance of a visible thrombus in 7 patients (53.8%). Overall, 6 patients received thrombectomy as 'stand-alone' procedure. All patients were discharged alive after a mean of 5.6+/-2 days.


English

1878-0938


*Coronary Thrombosis/th [Therapy]
*Myocardial Infarction/th [Therapy]
*Percutaneous Coronary Intervention
*Thrombectomy/mt [Methods]
Adult
Aged
Cardiac Catheters
Chi-Square Distribution
Coronary Angiography
Coronary Circulation
Coronary Thrombosis/co [Complications]
Coronary Thrombosis/pp [Physiopathology]
Coronary Thrombosis/ra [Radiography]
Equipment Design
Feasibility Studies
Female
Humans
Male
Middle Aged
Myocardial Infarction/et [Etiology]
Myocardial Infarction/pp [Physiopathology]
Myocardial Infarction/ra [Radiography]
Percutaneous Coronary Intervention/ae [Adverse Effects]
Recovery of Function
Retrospective Studies
Severity of Illness Index
Thrombectomy/ae [Adverse Effects]
Thrombectomy/is [Instrumentation]
Time Factors
Treatment Outcome


MedStar Heart & Vascular Institute


Journal Article