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Predictors of angiographically visible distal embolization in STEMI
N V Yaméogo1, C Guenancia2,3, G Porot1
1Cardiology Department, University Hospital, 14 rue Paul Gaffarel, 21079, Dijon CEDEX, France.
Herz
|June 22, 2018
Summary
Angiographically visible distal embolization (AVDE) occurs in 17% of ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention with thrombectomy. The right coronary artery and larger culprit lesions predict AVDE, even with successful thrombectomy.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Distal embolization during primary percutaneous coronary intervention (p-PCI) for ST-segment elevation myocardial infarction (STEMI) is linked to poor outcomes.
- Thrombectomy is employed to mitigate distal embolization and enhance myocardial reperfusion.
Purpose of the Study:
- To identify angiographic predictors of angiographically visible distal embolization (AVDE) in STEMI patients undergoing p-PCI with thrombectomy.
Main Methods:
- Prospective study of STEMI patients undergoing p-PCI with thrombectomy (October 2011-December 2014).
- AVDE defined as distal filling defect distal to the angioplasty site.
- Thrombectomy success assessed by thrombus removal and coronary flow improvement.
Main Results:
- 59 out of 346 patients (17%) experienced AVDE.
- Independent predictors for AVDE included infarct-related right coronary artery (OR: 2.48) and culprit lesion diameter >3 mm (OR: 1.90).
- Thrombectomy success and Syntax score were not associated with AVDE.
Conclusions:
- AVDE is a frequent complication (17%) of p-PCI with thrombectomy in STEMI.
- Successful thrombectomy does not preclude the occurrence of AVDE.
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