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Can thrombectomy and catheters used increase angiographically visible distal embolization in ST elevation myocardial

Cetin Sarikamis1, Nihan Turan Caglar2, Ismail Biyik3

  • 1Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.

Archives of Medical Sciences. Atherosclerotic Diseases
|September 15, 2017
PubMed

Insights

Manual thrombectomy during primary percutaneous coronary intervention (PPCI) increases angiographically visible distal embolisation (AVDE). The incidence of AVDE varied significantly based on the specific thrombectomy catheters utilized in the procedure.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Primary percutaneous coronary intervention (PPCI) is the gold standard for ST-segment elevation myocardial infarction (STEMI).
  • Manual thrombectomy catheters aim to reduce distal embolization but their clinical impact is debated.
  • The effect of these catheters on angiographically visible distal embolisation (AVDE) has not been previously investigated.

Purpose of the Study:

  • To evaluate the impact of manual thrombectomy during PPCI on AVDE.
  • To determine if different manual thrombectomy catheters influence the incidence of AVDE.

Main Methods:

  • A cohort of 636 patients undergoing PPCI between January 2010 and December 2012 was analyzed.
  • Patients were categorized into two groups: PPCI alone (465 patients) and PPCI with manual thrombectomy (171 patients).

Main Results:

  • Manual thrombectomy was associated with increased AVDE (26.9% vs. 13.55%), lower myocardial perfusion (Thrombolysis in Myocardial Infarction frame rate and Myocardial Blush Grade), reduced ejection fraction, and higher troponin levels.
  • No significant difference in mortality was observed between the groups.
  • Invatec catheters were linked to a higher incidence of AVDE.

Conclusions:

  • Angiographically visible distal embolisation is a frequent complication in patients undergoing manual thrombectomy during PPCI.
  • The choice of thrombectomy catheter may influence the occurrence of AVDE, suggesting a need for careful device selection.
Abstract

Keywords:
ST segment elevation myocardial infarctionangiographically visible distal embolisationcomplicationsprimary percutaneous coronary interventionthrombectomythrombectomy catheters

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