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Published on: January 18, 2018
Successful thrombus extraction with the Rescue thrombus management system during acute percutaneous coronary
Kunadian Vijayalakshmi1, Babu Kunadian, Robert A Wright
1Department of Cardiology, the James Cook University Hospital, Middlesbrough, United Kingdom.
Insights
The Rescue device effectively removed debris and improved coronary blood flow in most patients undergoing percutaneous coronary intervention for acute coronary syndrome. Further research is needed to confirm its impact on tissue perfusion and clinical outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Percutaneous coronary intervention (PCI) is a common treatment for acute coronary syndrome.
- Thrombus-laden coronary arteries pose challenges during PCI, potentially leading to suboptimal outcomes.
- Effective debris removal is crucial for successful PCI and improved myocardial perfusion.
Purpose of the Study:
- To evaluate the effectiveness of the Rescue device in restoring coronary blood flow and achieving optimal tissue perfusion.
- To assess the device's ability to aspirate debris during PCI in patients with thrombus-laden coronary arteries.
Main Methods:
- A prospective study involving 30 patients with acute coronary syndrome undergoing PCI.
- Utilized the Rescue device for potential thrombus aspiration prior to or during PCI.
- Assessed angiographic outcomes including TIMI frame count, thrombus score, TIMI flow grade, and myocardial blush grade.
Main Results:
- The Rescue device successfully aspirated debris in 87% of cases.
- Significant improvements were observed in TIMI frame count (P < 0.0001) and thrombus score (P < 0.0001) post-Rescue device use.
- TIMI flow grade 3 was achieved in 60% post-Rescue and 87% post-PCI; myocardial blush grade 3 in 13% post-Rescue and 37% post-PCI.
Conclusions:
- The Rescue device demonstrates capability in aspirating significant amounts of debris.
- The device effectively improves angiographic epicardial coronary blood flow.
- The clinical impact of the Rescue device on tissue perfusion and patient outcomes requires further investigation.
Unlabelled:
We determined the effectiveness of the Rescue device in restoring flow and achieving optimal tissue perfusion during percutaneous coronary intervention (PCI) in thrombus-laden coronary arteries.
Methods:
A total of 30 patients with an acute coronary syndrome underwent PCI using the Rescue device.
Results:
The mean age was 65.5 +/- 9.8 years. Although the Rescue device could not be passed across the lesion in 6 (20%) cases, debris was aspirated in 26 (87%). The uncorrected TIMI frame count improved following the use of the Rescue device and improved further at the completion of PCI (92.2 +/- 23.9 pre-PCI vs. 38.7 +/- 31.3 post-Rescue vs. 21.96 +/- 24 post-PCI, P < 0.0001). The thrombus score improved from 4 +/- 0 to 2.2 +/- 1.29 to 0.86 +/- 1.4 (P < 0.0001). TIMI flow grade (TFG) 3 was restored in 60% of cases following the Rescue device and in 87% after PCI. Myocardial blush grade 3 occurred in only 13% of patients following the Rescue device and 37% of patients after PCI.
Conclusion:
These data suggest that the Rescue device can aspirate considerable amounts of debris in the majority of patients and significantly improves the angiographic epicardial coronary blood flow. How effective such a device is in improving tissue perfusion and, thereby, clinical outcomes for patients remains to be seen.
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