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Published on: September 25, 2016
Novel use of the Heartrail catheter as a thrombectomy device
H M Hadi1, D G Fraser, M A Mamas
1Cardiology Department, University Hospital of Northern British Columbia, Prince George, B.C., Canada.
Insights
A novel stent delivery system, the "five-in-six" Heartrail catheter, effectively removed large thrombi during percutaneous coronary intervention (PCI) when standard aspiration failed. This approach offers a new option for high-risk PCI procedures involving significant thrombus burden.
Area of Science:
- Interventional Cardiology
- Cardiovascular Devices
- Thrombosis Management
Background:
- Thrombus presence during percutaneous coronary intervention (PCI) correlates with adverse outcomes.
- Large thrombus burden in saphenous vein grafts (SVGs) and primary PCI poses significant risks.
- Mechanical thrombectomy aims to reduce thrombus burden and prevent complications like distal embolization and no-reflow.
Observation:
- This report details three successful cases utilizing a specific stent delivery system as a thrombectomy device.
- The device, a "five-in-six" Heartrail catheter, features a wide-bore lumen.
- Its use was successful in SVG lesions and primary PCI scenarios.
Findings:
- The "five-in-six" Heartrail catheter demonstrated efficacy in thrombectomy for complex PCI cases.
- Successful application was noted following the failure of conventional simple aspiration thrombectomy catheters.
- This device facilitated thrombus removal in challenging SVG lesions and primary PCI.
Implications:
- The "five-in-six" Heartrail catheter presents a viable alternative thrombectomy tool for high-risk PCI.
- This expands mechanical thrombectomy options for interventional cardiologists.
- Improved patient outcomes may be achievable in complex PCI with significant thrombus burden.
Abstract:
The presence of thrombus is independently associated with adverse outcomes during percutaneous coronary intervention (PCI), particularly in those cases involving a large thrombus burden such as in saphenous vein grafts (SVGs) or during primary PCI. Mechanical thrombectomy devices are used to reduce the thrombus burden in such high-risk procedures to reduce the risk of distal embolization and slow flow and no-reflow. Here we describe 3 cases of successful use of a stent delivery system with a wide-bore lumen, the "five-in-six" Heartrail catheter, as a thrombectomy device in SVG lesions and primary PCI following failure of conventional simple aspiration thrombectomy catheters.
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