Related Experiment Video

Updated: Jul 23, 2025

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.1K

Double protection in patients with a massive thrombus in the infarct-related artery - a single-center retrospective

Piotr Chodór1, Grzegorz Honisz1, Krzysztof Wilczek2

  • 1Silesian Center for Heart Diseases, Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia, Zabrze, Poland.

Postepy W Kardiologii Interwencyjnej = Advances in Interventional Cardiology
|July 19, 2023
PubMed

Insights

Double protection (DP) using manual thrombectomy with a distal protection device is a safe and feasible approach for patients experiencing ST-segment elevation myocardial infarction (STEMI) with massive thrombus (MT). Further studies are needed to confirm its efficacy in improving outcomes for these critical cardiac events.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • ST-segment elevation myocardial infarction (STEMI) involves thrombus formation on atherosclerotic plaques.
  • Massive thrombus (MT) in STEMI can lead to severe complications like extensive myocardial infarction (MI) and impaired reperfusion.
  • Current treatments for coronary thrombi exist, but the efficacy of double protection (DP) combining manual thrombectomy (MTH) with a distal protection device (DPD) remains unevaluated.

Purpose of the Study:

  • To evaluate the outcomes of the double protection (DP) strategy in patients presenting with STEMI and MT.
  • To assess the safety and feasibility of DP as a treatment for STEMI with MT.

Main Methods:

  • A study included fourteen patients diagnosed with STEMI and MT.
  • All patients underwent primary percutaneous coronary intervention (PPCI) utilizing the DP technique.
  • DP involved manual thrombectomy (MTH) combined with a distal protection device (DPD).

Main Results:

  • Inferior MI was prevalent, affecting 12 (85.8%) patients.
  • Stent implantation was performed in 13 (92.8%) patients.
  • A high thrombus burden was observed, with Thrombolysis In Myocardial Infarction (TIMI) Thrombus Grade 5 in 11 (78.6%) and Grade 4 in 3 (21.4%) patients, and a median thrombus length of 39.1 mm.
  • Complete reperfusion (TIMI flow 3) was achieved in 11 (78.6%) patients, with TIMI flow 2 in 3 (21.4%).
  • Myocardial Blush Grade 3 was noted in 5 (35.7%) patients with TIMI flow 3.
  • Significant ST-segment elevation resolution (>50%) occurred in 13 (92.8%) patients.
  • No in-hospital adverse events such as myocardial rupture, stroke, or death were reported.

Conclusions:

  • The double protection (DP) strategy, incorporating MTH and DPD, is a safe and feasible procedural option for managing patients with STEMI and MT.
  • While initial results suggest safety, further extensive research and clinical trials are necessary to definitively establish the efficacy of DP in improving long-term patient outcomes.
Abstract

Keywords:
ST-segment elevation myocardial infarctiondistal protection devicemanual thrombectomymassive thrombusprimary percutaneous coronary intervention

More Related Videos

Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli13:10

Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli

Published on: September 25, 2016

10.0K
A Fibrin-Enriched and tPA-Sensitive Photothrombotic Stroke Model09:42

A Fibrin-Enriched and tPA-Sensitive Photothrombotic Stroke Model

Published on: June 4, 2021

2.8K

Related Concept Videos

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
10
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10