Successful thrombus extraction with the Rescue™ thrombus management system during acute percutaneous coronary intervention improves flow but does not necessarily restore optimal myocardial tissue perfusion

We determined the effectiveness of the Rescue™ device in restoring flow and achieving optimal tissue perfusion during percutaneous coronary intervention (PCI) in thrombus‐laden coronary arteries. Methods: A total of 30 patients with an acute coronary syndrome underwent PCI using the Rescue device. Results: The mean age was 65.5 ± 9.8 years. Although the Rescue device could not be passed across the lesion in 6 (20%) cases, debris was aspirated in 26 (87%). The uncorrected TIMI frame count improved following the use of the Rescue device and improved further at the completion of PCI (92.2 ± 23.9 pre‐PCI vs. 38.7 ± 31.3 post‐Rescue vs. 21.96 ± 24 post‐PCI, P < 0.0001). The thrombus score improved from 4 ± 0 to 2.2 ± 1.29 to 0.86 ± 1.4 ( P < 0.0001). TIMI flow grade (TFG) 3 was restored in 60% of cases following the Rescue device and in 87% after PCI. Myocardial blush grade 3 occurred in only 13% of patients following the Rescue device and 37% of patients after PCI. Conclusion: These data suggest that the Rescue device can aspirate considerable amounts of debris in the majority of patients and significantly improves the angiographic epicardial coronary blood flow. How effective such a device is in improving tissue perfusion and, thereby, clinical outcomes for patients remains to be seen. © 2006 Wiley‐Liss Inc.