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Aims: We aimed to investigate whether thrombus aspiration could preserve the index of microcirculatory resistance (IMR) after primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI).
Methods And Results: Sixty-three patients with STEMI were randomised into two groups: primary PCI after thrombus aspiration (aspiration group, n=33) and primary PCI without thrombus aspiration (non-aspiration group, n=30). IMR was measured using a pressure-temperature sensor-tipped coronary wire. Echocardiography was performed at baseline and at six-month follow-up. No significant differences in baseline ejection fraction (EF, 47.3±8.5% vs. 49.5±7.8%, p=0.281) and baseline wall motion score index (WMSI, 1.45±0.31 vs. 1.37±0.27, p=0.299) were observed between the two groups. However, significant differences in IMR (23.5±10.2 U vs. 34.2±21.7 U, p=0.018), %E2%88%86EF (follow-up EF - baseline EF; 3.33±4.6% vs. 0.73±1.9%, p=0.005), and %E2%88%86WMSI (follow-up WMSI - baseline WMSI; -0.121±0.16 vs. -0.004±0.07, p=0.001) were observed between the two groups.
Conclusions: Thrombus aspiration as an adjunctive method to primary PCI for STEMI may preserve microvascular integrity and have beneficial effects on myocardial microcirculation.
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http://dx.doi.org/10.4244/EIJV9I9A179 | DOI Listing |
Int J Cardiol Congenit Heart Dis
September 2024
Cardiology Department, La Paz University Hospital, Paseo de la Castellana, 261, 28046 Madrid, Spain.
Background: Obstructive complications in the Fontan circulation pose significant risks to affected patients. Traditional management strategies may be insufficient, necessitating innovative treatment approaches. This case report discusses the use of the FlowTriever Retrieval System for percutaneous aspiration thrombectomy in a patient with a history of Fontan procedure who developed conduit obstruction due to thrombus formation.
View Article and Find Full Text PDFJ Endovasc Ther
December 2024
Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Background: Pulmonary embolism (PE) is an important cause of death and disability. Advances in catheter-directed therapies have led to the use of devices, such as the Inari FlowTriever and Penumbra Indigo system for aspiration thrombectomy (AT) for both massive and sub-massive PE. However, limited data exist on causes of procedural mortality.
View Article and Find Full Text PDFInt J Emerg Med
December 2024
Department of Critical Care Medicine, Zhongda Hospital, Southeast University, No.87, Dingjiaqiao, Gulou District, Nanjing, 210009, China.
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been utilized to treat massive pulmonary embolism (PE) accompanied by cardiac arrest or refractory cardiogenic shock. Our team opted for a femoral-femoral approach for vascular cannulation, using drainage and return cannulas in the common femoral vein and artery, respectively. However, femoral venous cannulation can be limited or challenging due to the presence of thrombus in the inferior vena cava (IVC), making the insertion of the drainage cannula via the femoral vein difficult.
View Article and Find Full Text PDFInterv Neuroradiol
December 2024
Department of Neurology, Neurological Surgery and Radiology, Indiana University School of Medicine, Indianapolis, IN, USA.
Mechanical thrombectomy has become the cornerstone to achieve reperfusion in large vessel occlusion causing acute ischemic stroke. Since the advent of intracranial thrombectomy, the procedural setup has been to deliver aspiration catheter over microwire and microcatheter to the intracranial occlusion (ADAPT) or to deliver the stent-retriever through the microcatheter (SOLUMBRA) to perform thrombectomy. In both these techniques the quintessential aspect is crossing the clot/thrombus, which increases the chances of clot fragmentation or disruption.
View Article and Find Full Text PDFAm J Case Rep
December 2024
Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China.
BACKGROUND Coronary artery ectasia (CAE) represents not only an anatomical variant but also a clinical constellation of coronary artery disease associated with acute coronary syndrome (ACS). There is no consensus on the antithrombotic treatment for patients with CEA. CASE REPORT A 34-year-old man with severe diffuse dilatation of the left main artery and left circumflex (LCX) proximal segment confirmed by coronary angiography (CAG) developed 2 acute myocardial infarctions (AMIs), due to occlusion of a dilated LCX segment with thrombus shadows, within a 9-year interval.
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