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Thrombus capture by withdrawal of an open filter device: a useful treatment for large non-occlusive coronary thrombus

Samer Arnous1, Maria Agelaki, Nizar Shakhshir

  • 1Manchester Heart Centre, Manchester Royal Infirmary, Biomedical Research Centre, Manchester, United Kingdom.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|October 21, 2014
PubMed

Insights

This study shows that the ev3 Spider™ filter device safely and effectively removes large coronary thrombi resistant to standard treatments. This novel technique achieved successful thrombus removal and TIMI 3 flow in all patients, reducing no-reflow risk.

Area of Science:

  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Large "cannon-ball" non-occlusive intracoronary thrombi pose treatment challenges.
  • Standard thrombectomy aspiration catheters are often ineffective for these large thrombi.

Purpose of the Study:

  • To evaluate the safety and feasibility of using the ev3 Spider™ filter device for manual removal of non-occlusive coronary thrombus.
  • To assess the efficacy of this novel technique in achieving substantial thrombus removal and restoring coronary blood flow.

Main Methods:

  • A case series of nine patients with large, non-occlusive intracoronary thrombi refractory to standard aspiration thrombectomy.
  • Utilized the ev3 Spider™ filter device for manual thrombus retrieval.
  • Assessed procedural success, prevention of no-reflow/slow flow, and achievement of TIMI 3 flow post-intervention.

Main Results:

  • The ev3 Spider™ filter device successfully achieved substantial or complete thrombus removal in all nine patients.
  • Prevention of no-reflow/slow flow phenomenon and TIMI 3 flow post-stenting were achieved in all cases.
  • One instance of coronary dissection occurred in a heavily calcified lesion; no other device-related complications were reported.

Conclusions:

  • Manual removal of large intracoronary thrombi using the ev3 Spider™ filter device is a safe and feasible option.
  • This technique demonstrates a high procedural success rate and may reduce the risk of no-reflow in complex thrombus cases.
  • This is the first case series to describe the use of the ev3 Spider™ filter device for refractory intracoronary thrombus removal.
Abstract

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