Time for contrast material to traverse the epicardial artery and the myocardium in ST-segment elevation acute myocardial infarction versus unstable angina pectoris/non-ST-elevation acute myocardial infarction.

Although the time for contrast material to fill the epicardial artery in the setting of acute coronary syndromes has been studied extensively, the time for contrast material to fill the myocardium has not been evaluated. We compared differences in myocardial contrast material transit among patients with unstable angina pectoris/non-ST-elevation acute myocardial infarction (UAP/NSTEAMI) with patients with ST-elevation acute myocardial infarction (STEAMI). The time it took for contrast material to first appear and to arrive at peak intensity in the myocardium was compared in 224 patients with STEAMI enrolled in the LIMIT-AMI study versus 430 patients with UAP/NSTEAMI enrolled in the TACTICS-TIMI 18 trial.

Effectiveness of rheolytic coronary thrombectomy with the AngioJet catheter.

Thrombus-filled lesions are associated with a higher rate of acute complications and long-term restenosis following conventional coronary or saphenous vein graft (SVG) intervention. To evaluate the clinical effectiveness of rheolytic thrombectomy in a nonselected population in the glycoprotein IIb/IIIa blockade era, we reviewed clinical, angiographic, and procedural data on 119 patients who underwent 126 consecutive coronary AngioJet procedures (29% in SVGs, and 71% in native coronary arteries) from July 1998 to August 2000. Glycoprotein IIb/IIIa blockers were used in 88%.

Rheolytic thrombectomy and platelet glycoprotein IIb/IIIa blockade for stent thrombosis.

Conventional transcatheter-based strategies result in good procedural success but poor clinical outcome in the treatment of intracoronary stent thrombosis. A combined approach of mechanical thrombus burden reduction using AngioJet rheolytic thrombectomy with adjunctive glycoprotein (GP) IIb/IIIa antagonists has not been studied. Between July 1998 and August 2000, 15 patients (17 procedures) underwent AngioJet thrombectomy for stent thrombosis at the Beth Israel Deaconess Medical Center.