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AngioJet thrombectomy and stenting for reperfusion in acute MI complicated with cardiogenic shock
Behzad Taghizadeh1, J Andy Chiu, Rafael Papaleo
1The Heart Institute at Albany Medical Center, Albany, New York 12208, USA.
Insights
AngioJet thrombectomy (AJ) is safe and effective for acute myocardial infarction (AMI) with cardiogenic shock (CS). This treatment allows immediate intervention, potentially improving survival rates in high-risk patients.
Area of Science:
- Interventional Cardiology
- Acute Myocardial Infarction Treatment
- Cardiogenic Shock Management
Background:
- Acute myocardial infarction (AMI) with cardiogenic shock (CS) is a high-mortality condition.
- AngioJet thrombectomy (AJ) is established for AMI but less studied in CS.
- Immediate revascularization is crucial for AMI-CS patients.
Observation:
- Retrospective analysis of 19 patients with AMI and CS treated with AJ and immediate stenting.
- Procedure success defined as <50% stenosis and TIMI flow ≥2.
- Clinical success defined as procedure success without major in-hospital cardiac events.
Findings:
- 95% procedure success rate, with 89% achieving final TIMI 3 flow.
- 68% clinical success rate, with 5 in-hospital deaths.
- No strokes or emergent bypass surgeries; low 30-day mortality and revascularization rates.
Implications:
- AJ is a relatively safe and effective option for AMI complicated by CS.
- Facilitates immediate definitive treatment, potentially improving outcomes.
- Suggests a strategy to reduce mortality in this high-risk AMI-CS patient population.
Abstract:
AngioJet thrombectomy (AJ) has been shown to be safe and effective in treatment of acute myocardial infarction (AMI). However, use of AJ has not been studied extensively in AMI with cardiogenic shock (CS). Clinical outcomes in 19 patients with CS and treated with AJ were retrospectively analyzed. Immediate stenting was also performed. Procedure success (final diameter stenosis < 50% and TIMI flow > or = 2) was achieved in 95%, with final TIMI 3 flow in 89%. Clinical success (procedure success without major in-hospital cardiac events) was achieved in 68%. There were five in-hospital deaths and no patients experienced stroke or required emergent bypass surgery. At 30-day follow-up, there were no additional deaths or stroke, and two patients had undergone target vessel revascularization. AJ is relatively safe and effective in the setting of AMI complicated with CS, allowing for immediate definitive treatment. This strategy may offer improved mortality in these high-risk patients.