Micro-CT-Based Quantification of Extracted Thrombus Burden Characteristics and Association With Angiographic Outcomes
Efstratios Karagiannidis1, Andreas S Papazoglou1, Georgios Sofidis1
1First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Frontiers in Cardiovascular Medicine
|May 10, 2021
Summary
Micro-computed tomography (micro-CT) analysis of thrombus in ST-elevation myocardial infarction (STEMI) reveals larger thrombus volume and surface are linked to adverse outcomes. Current thrombectomy devices inadequately manage high thrombus burden, necessitating improved technologies.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Imaging
Background:
- Thrombus in ST-elevation myocardial infarction (STEMI) correlates with poor prognosis.
- Routine thrombus aspiration has not consistently improved outcomes.
- Managing high coronary thrombus burden remains a clinical challenge.
Purpose of the Study:
- To characterize extracted thrombus material using micro-computed tomography (micro-CT).
- To correlate thrombus characteristics with angiographic and electrocardiographic outcomes in STEMI patients.
Main Methods:
- 113 STEMI patients undergoing thrombus aspiration were analyzed.
- Micro-CT quantified thrombus volume, surface area, and density.
- Statistical analysis correlated these indices with clinical outcomes.
Main Results:
- Larger thrombus volume and surface area were significantly associated with higher angiographic thrombus burden.
- Thrombus volume and surface predicted distal embolization, no-reflow, and residual thrombus.
- Higher thrombus density correlated with worse pre-procedural flow; larger thrombus load was linked to less ST resolution.
Conclusions:
- Larger extracted thrombus in STEMI patients is associated with adverse angiographic outcomes.
- Current thrombectomy devices are insufficient for managing significant thrombus loads.
- Novel thrombus aspiration technologies are needed to improve patient outcomes.
Keywords:
ST-elevation myocardial infarctioninterventional cardiologymicro-computed tomographythrombusthrombus aspirationMore Related Videos
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
191
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
191
01:28Imaging Studies for Cardiovascular System V: CT
124
Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
124
01:30Acute Coronary Syndrome III: Diagnostic Studies
65
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
65