Intracoronary glycoprotein IIb/IIIa inhibitor infusion via a perfusion coronary catheter to decrease thrombus burden: results from the ClearWay Multicenter Registry.

MedStar author(s):
Citation: Cardiovascular Revascularization Medicine. 14(5):280-3, 2013 Sep-Oct.PMID: 23375788Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter StudySubject headings: *Cardiac Catheterization/is [Instrumentation] | *Cardiac Catheters | *Coronary Artery Disease/th [Therapy] | *Coronary Thrombosis/th [Therapy] | *Coronary Vessels/de [Drug Effects] | *Percutaneous Coronary Intervention | *Platelet Aggregation Inhibitors/ad [Administration & Dosage] | *Platelet Glycoprotein GPIIb-IIIa Complex/ai [Antagonists & Inhibitors] | Aged | Coronary Angiography | Coronary Artery Disease/bl [Blood] | Coronary Artery Disease/di [Diagnosis] | Coronary Artery Disease/pp [Physiopathology] | Coronary Circulation/de [Drug Effects] | Coronary Thrombosis/bl [Blood] | Coronary Thrombosis/di [Diagnosis] | Coronary Thrombosis/pp [Physiopathology] | Coronary Vessels/pp [Physiopathology] | Coronary Vessels/ra [Radiography] | Equipment Design | Female | Health Care Surveys | Humans | Infusions, Intra-Arterial | Male | Middle Aged | Percutaneous Coronary Intervention/ae [Adverse Effects] | Platelet Glycoprotein GPIIb-IIIa Complex/me [Metabolism] | Questionnaires | Registries | Time Factors | Treatment Outcome | United StatesLocal holdings: Available in print through MWHC library: 2002 - presentISSN:
  • 1878-0938
Name of journal: Cardiovascular revascularization medicine : including molecular interventionsAbstract: BACKGROUND: The presence or development of thrombus during PCI is associated with poor prognosis.CONCLUSION: Intracoronary infusion of GP IIb/IIIa inhibitors via the perfusion CW catheter is associated with significant reduction in thrombus burden and with improvement of the coronary flow in patients presenting or developing thrombus burden during PCI. Copyright 2013. Published by Elsevier Inc.METHODS: The utility of the CW perfusion catheter was assessed in patients who presented with intracoronary thrombus and were subjected to PCI. Data were collected by online survey from 15 US sites. Angiographic assessment of the coronary thrombus burden and the coronary flow after intracoronary infusion of glycoprotein (GP) IIb/IIIa inhibitors via the CW catheter was evaluated at baseline, immediately after infusion, and at the end of the procedure. The cohort included 102 patients; 71.6% presented with ST-elevation myocardial infarction (MI), 21.6% with non-ST-elevation MI, 5.9% with stable angina pectoris, and 2.9% with silent ischemia. The mean cohort age was 59.9+14.5years and comprised mostly of men (72.5%).OBJECTIVES: This multicenter registry aimed to assess the ClearWay (CW) perfusion catheter in reduction of thrombus burden and improvement of the coronary flow during percutaneous coronary intervention (PCI).RESULTS: GP IIb/IIIa inhibitors were infused via the CW catheter on average 1.1+0.3 times, with a mean pressure of 4.2+2.7atm and a mean infusion time of 55+55s. Following the infusion, Thrombolysis In Myocardial Infarction (TIMI) flow improved by 1degree in 71 patients (69.6%) and by 2degree in 51 patients (50%), while visible thrombus was reduced by 52% (p<0.001). In the final angiogram, TIMI flow was restored in 90.2% and clearance of a visible thrombus was obtained in 91.8% of the lesions.All authors: Arora DS, Ben-Dor I, Cavros N, Clearway Registry Investigators, Deibele A, Makam S, Maluenda G, McElroy BB, Revtyak G, Sizemore BC, Torguson R, Waksman RDigital Object Identifier: Date added to catalog: 2014-08-21
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Journal Article MedStar Authors Catalog Article Available 23375788

Available in print through MWHC library: 2002 - present

BACKGROUND: The presence or development of thrombus during PCI is associated with poor prognosis.

CONCLUSION: Intracoronary infusion of GP IIb/IIIa inhibitors via the perfusion CW catheter is associated with significant reduction in thrombus burden and with improvement of the coronary flow in patients presenting or developing thrombus burden during PCI. Copyright 2013. Published by Elsevier Inc.

METHODS: The utility of the CW perfusion catheter was assessed in patients who presented with intracoronary thrombus and were subjected to PCI. Data were collected by online survey from 15 US sites. Angiographic assessment of the coronary thrombus burden and the coronary flow after intracoronary infusion of glycoprotein (GP) IIb/IIIa inhibitors via the CW catheter was evaluated at baseline, immediately after infusion, and at the end of the procedure. The cohort included 102 patients; 71.6% presented with ST-elevation myocardial infarction (MI), 21.6% with non-ST-elevation MI, 5.9% with stable angina pectoris, and 2.9% with silent ischemia. The mean cohort age was 59.9+14.5years and comprised mostly of men (72.5%).

OBJECTIVES: This multicenter registry aimed to assess the ClearWay (CW) perfusion catheter in reduction of thrombus burden and improvement of the coronary flow during percutaneous coronary intervention (PCI).

RESULTS: GP IIb/IIIa inhibitors were infused via the CW catheter on average 1.1+0.3 times, with a mean pressure of 4.2+2.7atm and a mean infusion time of 55+55s. Following the infusion, Thrombolysis In Myocardial Infarction (TIMI) flow improved by 1degree in 71 patients (69.6%) and by 2degree in 51 patients (50%), while visible thrombus was reduced by 52% (p<0.001). In the final angiogram, TIMI flow was restored in 90.2% and clearance of a visible thrombus was obtained in 91.8% of the lesions.

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