'Mother-in-child' thrombectomy technique: a novel and effective approach to decrease intracoronary thrombus burden in...

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Medicine

Background:

• Large thrombus burden in acute myocardial infarction (AMI) is common and linked to poor prognosis.
• Percutaneous coronary intervention (PCI) is a standard treatment for AMI.
• Effective thrombus removal is crucial for successful PCI outcomes.

Purpose of the Study:

• To evaluate the feasibility and safety of the novel 'mother-in-child' thrombectomy (MCT) technique.
• To assess the efficacy of MCT in reducing thrombus burden in AMI patients undergoing PCI.
• To determine the impact of MCT on coronary blood flow and angiographic outcomes.

Main Methods:

• A prospective study involving 13 patients with AMI and significant intracoronary thrombus after initial thrombectomy.
• The 'mother-in-child' thrombectomy (MCT) procedure was performed using a 5F 'Heartrail II-ST01' catheter within a 6F guiding system.
• Angiographic assessment of thrombus burden and coronary flow (TIMI flow and myocardial blush) was conducted at baseline, post-thrombectomy, and post-PCI.

Main Results:

• MCT significantly improved Thrombolysis In Myocardial Infarction (TIMI) flow by at least 2 degrees in 84.5% of patients.
• Visible thrombus burden was reduced in 84.5% of patients, with normal TIMI flow restored in 84.5%.
• Normal myocardial blush was achieved in 53.8% of patients, and complete thrombus clearance was observed in 53.8%.

Conclusions:

• The 'mother-in-child' thrombectomy (MCT) technique is a feasible and safe approach for managing large thrombus burden in AMI patients.
• MCT effectively reduces thrombus burden and improves coronary blood flow during PCI.
• This novel technique offers a promising option for improving outcomes in selected AMI patients.