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Frequency and predictors of thrombus inside the guiding catheter during interventional procedures: an optical coherence tomography study

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Abstract

Optical coherence tomography (OCT) is able to identify thrombus. We detect the frequency of thrombus inside the guiding catheter by OCT and its relationship with clinical and procedural factors. We screened 77 patients who underwent OCT pullbacks. Only patients with visible guiding catheter were finally included (35) and divided into thrombus (21) or no-thrombus group (14). Patients within thrombus group were mostly males (100 vs. 71 %, p = 0.05), with acute coronary syndrome (76 vs. 36 %, p = 0.02) and received more frequently percutaneous coronary intervention (86 vs. 43 %, p = 0.01) as compared to other group. A second dose of heparin was more frequently administered in thrombus than in other group (86 vs. 50 %, p = 0.01). Time between first heparin administration and OCT pullback (41[28–57] vs. 20 min [10–32], p = 0.001), time elapsed from second heparin administration and OCT pullback (29 [19–48] vs. 16 min [12–22], p = 0.002) and total procedural time (47 [36–69] vs. 31 min [26–39], p = 0.005) were longer in thrombus compared to other group. At multivariate analysis, total procedural time and time between first heparin administration and OCT pullback were only predictors of intra-catheter thrombus (HR 0.6 [0.3–0.9], p = 0.03 and HR 1.9 [1.1–3.2], p = 0.02, respectively). Thrombus inside guiding catheter may be a frequent finding in long interventional procedure. Future studies are warranted to determine its clinical impact.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

The authors state that this study have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study

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Authors and Affiliations

  1. Department of Cardiology, Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain

    Giancarla Scalone, Salvatore Brugaletta, Victoria Martin-Yuste, Yajaziel Azpeitia, Shuji Otsuki, Omar Gomez, Xavier Freixa, Monica Masotti & Manel Sabaté

  2. Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands

    Hector M. Garcia-Garcia

Authors
  1. Giancarla Scalone
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  2. Salvatore Brugaletta
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  3. Hector M. Garcia-Garcia
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  5. Yajaziel Azpeitia
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  6. Shuji Otsuki
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  9. Monica Masotti
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Correspondence to Salvatore Brugaletta.

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Scalone, G., Brugaletta, S., Garcia-Garcia, H.M. et al. Frequency and predictors of thrombus inside the guiding catheter during interventional procedures: an optical coherence tomography study. Int J Cardiovasc Imaging 31, 239–246 (2015). https://doi.org/10.1007/s10554-014-0544-3

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  • DOI: https://doi.org/10.1007/s10554-014-0544-3

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