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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
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Neurointerventional tools and techniques for coronary thrombus removal. A case-based review
Jacek Klaudel1, Wojciech Trenkner1, Krzysztof Pawłowski2
1Department of Invasive Cardiology and Interventional Radiology, St. Adalbert's Hospital, Copernicus Podmiot Leczniczy Sp. z o.o., Gdansk, Poland.
Journal of Cardiology Cases
|December 12, 2022
Summary
Neurointerventional catheters offer a novel solution for removing large coronary clots when standard aspiration devices fail. These catheters enabled successful first-pass reperfusion in three complex cases, improving treatment options for myocardial infarction.
Area of Science:
- Interventional Cardiology
- Neurointerventional Radiology
Background:
- Aspiration thrombectomy's role in myocardial infarction is limited due to negative study results, with minimal recent technological progress.
- Mechanical thrombectomy has advanced rapidly in stroke treatment due to the embolic nature of most ischemic events.
Observation:
- Three transradial procedures utilized neurointerventional catheters as a primary tool for en bloc clot removal in distal, tortuous coronary arteries.
- This approach successfully cleared large thrombi in all cases.
Findings:
- First-pass reperfusion was achieved in all three procedures.
- No instances of arterial dissection, distal embolization, or the no-reflow phenomenon were observed.
Implications:
- Neurointerventional catheters can serve as a rescue strategy for large coronary clots unresponsive to standard aspiration devices.
- Their large aspiration lumen, trackability, and atraumatic design enhance safety and efficacy.
- Adopting neurointerventional techniques may significantly improve coronary thrombus aspiration outcomes.
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