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Rheolytic thrombectomy in patients with acute coronary syndrome and large thrombus burden: initial and mid-term

Petros Dardas1, Nikos Mezilis, Vlasis Ninios

  • 1Department of Cardiology and Cardiothoracic Surgery, St. Luke's Hospital, Thessaloniki, Greece. pdardas@otenet.gr

Hellenic Journal of Cardiology : HJC = Hellenike Kardiologike Epitheorese
|February 2, 2010
PubMed

Insights

Rheolytic thrombectomy (RT) is a feasible and safe approach for patients with acute coronary syndrome (ACS) and large thrombus burden during percutaneous coronary intervention (PCI). RT reduces no-reflow complications, improving outcomes.

Area of Science:

  • Interventional Cardiology
  • Cardiovascular Research
  • Acute Coronary Syndromes

Background:

  • Large intracoronary thrombus burden complicates percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS).
  • Rheolytic thrombectomy (RT) is a proposed intervention, but its efficacy remains debated.

Purpose of the Study:

  • To evaluate the feasibility and safety of rheolytic thrombectomy (RT) in patients with ACS and large thrombus burden undergoing PCI.

Main Methods:

  • A single-centre, retrospective, observational case-control study.
  • Compared 26 consecutive ACS patients with large thrombus burden undergoing RT to 26 matched controls.
  • Matching criteria included artery location and initial TIMI flow grade.

Main Results:

  • The RT group had a higher prevalence of ST-elevation myocardial infarction and larger thrombus burden.
  • RT group showed reduced distal embolisation/no-reflow and less need for vasoactive agents.
  • Final TIMI flow and major adverse coronary events were similar between groups.

Conclusions:

  • Rheolytic thrombectomy (RT) is feasible and safe for acute PCI in ACS patients with large thrombus burden.
  • RT effectively reduces the incidence of the no-reflow phenomenon.
Abstract

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