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Adjunctive thrombus aspiration and mechanical protection from distal embolization in primary percutaneous intervention for acute myocardial infarction
Author(s) -
Belli Guido,
Pezzano Antonio,
De Biase Anna Maria,
Bonacina Edgardo,
Silva Pedro,
Salvadè Paolo,
Piccalò Giacomo,
Klugmann Silvio
Publication year - 2000
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/1522-726x(200007)50:3<362::aid-ccd22>3.0.co;2-h
Subject(s) - medicine , thrombus , percutaneous coronary intervention , myocardial infarction , percutaneous , embolization , radiology , cardiology , surgery , circumflex , artery
Primary percutaneous intervention for acute occlusion of a native coronary artery may be complicated by distal embolization of plaque or thrombotic debris, with infarct extension. We tested the clinical application of a new therapeutic strategy combining maximal antiplatelet therapy, with glycoprotein IIb/IIIa inhibition, and adjunctive mechanical protection from distal embolization and direct aspiration of thrombus with a new balloon and catheter system (PercuSurge™). Successful aspiration of thrombus could be obtained in 7 out of 8 attempted procedures, with inability to negotiate the angulated take‐off of the circumflex coronary artery in one patient. The current mechanical characteristics of the device, primarily developed for use in larger saphenous vein grafts, and certain caveats and limitations are discussed. New dedicated systems should be available in the near future for the native coronary circulation. Excellent immediate angiographic results were obtained in all treated patients, without evidence of loss of distal branches and no intraprocedural complications. Cathet. Cardiovasc. Intervent. 50:362–370, 2000. © 2000 Wiley‐Liss, Inc.