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Feasibility and safety of thrombectomy with TVAC aspiration catheter system for patients with acute myocardial infarction

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Abstract

Early reperfusion with angioplasty and stenting is established as a central, effective treatment for acute myocardial infarction (AMI). The role of thrombectomy prior to angioplasty remains to be elucidated. To evaluate its feasibility, safety, and efficacy, thrombectomy using a TVAC aspiration catheter system was attempted prior to angioplasty and stenting in 40 consecutive patients with AMI. Fifty consecutive patients with AMI in whom angioplasty and stenting were performed without prior thrombectomy served as controls. Neither distribution of Killip classification nor culprit lesion was different between the two groups. In patients treated with the TVAC system, the procedure was successful in 39/40 patients (98%) and there were no procedure-related complications. In the final coronary angiogram, TIMI-3 (Thrombolysis in Myocardial Infarction) flow was obtained in 37/40 (93%) in patients treated with the TVAC system and 43/50 (86%) in control patients. Electrocardiograms before and after coronary intervention were analyzed in patients with ST elevation AMI (35 patients treated with the TVAC system and 41 control patients). ST elevation recovery >50% of the initial value was observed after coronary intervention in 26/35 (74%) in patients treated with the TVAC system and 26/41 (63%) in control patients (P = 0.33). In the case of anterior AMI, ST elevation recovery >50% of the initial value was observed in 13/17 (76%) in patients treated with the TVAC system and 8/20 (40%) in control patients (P = 0.045). Thus, thrombectomy using a TVAC system is feasible, safe, and may have the potential to enhance ST-segment resolution in patients with anterior AMI.

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References

  1. P Libby (1995) ArticleTitleMolecular bases of the acute coronary syndromes Circulation 91 2844–2850 Occurrence Handle1:STN:280:ByqB2sjptlM%3D Occurrence Handle7758192

    CAS  PubMed  Google Scholar 

  2. E Falk PK Shah V Fuster (1995) ArticleTitleCoronary plaque disruption Circulation 92 657–671 Occurrence Handle1:STN:280:ByqA287hs1U%3D Occurrence Handle7634481

    CAS  PubMed  Google Scholar 

  3. F Zijlstra MJ de Bore JC Hoorngje S Reiffers JH Reiber H Suryapranata (1993) ArticleTitleA comparison of immediate coronary angioplasty with intravenous streptokinase in acute myocardial infarction N Engl J Med 328 680–684 Occurrence Handle10.1056/NEJM199303113281002 Occurrence Handle1:STN:280:ByyC28rgvV0%3D Occurrence Handle8433726

    Article  CAS  PubMed  Google Scholar 

  4. S Saito FG Hosokawa K Kim S Tanaka S Miyake (1996) ArticleTitlePrimary stent implantation without coumadin in acute myocardial infarction J Am Coll Cardiol 28 74–81 Occurrence Handle10.1016/0735-1097(96)00125-8 Occurrence Handle1:STN:280:BymB1cngvFU%3D Occurrence Handle8752797

    Article  CAS  PubMed  Google Scholar 

  5. S Saito G Hosokawa S Tanaka S Nakamura (1999) ArticleTitlePrimary stent implantation is superior to balloon angioplasty in acute myocardial infarction: final results of the primary angioplasty versus stent implantation in acute myocardial infarction (PASTA) trial. PASTA Trial Investigators Catheter Cardivoasc Interv 48 262–268 Occurrence Handle1:STN:280:DyaK1MvlsFajtQ%3D%3D Occurrence Handle10.1002/(SICI)1522-726X(199911)48:3<262::AID-CCD5>3.0.CO;2-4

    Article  CAS  Google Scholar 

  6. E Braunwald RH Jones DB Mark J Brown L Brown MD Cheitlin M Concannon C Edwards V Fuster (1994) ArticleTitleDiagnosing and managing unstable angina Circulation 90 613–622 Occurrence Handle1:STN:280:ByuB1MfitVI%3D Occurrence Handle8026048

    CAS  PubMed  Google Scholar 

  7. CJ White SR Ramee TJ Collins AE Escobar A Karasan D Shaw SP Jain TA Bass RR Heuser PS Teirstein R Bonan PD Walter RW Smalling (1996) ArticleTitleCoronary thrombi increase PTCA risk: angioscopy as a clinical tool Circulation 93 253–258 Occurrence Handle1:STN:280:BymC3svktVU%3D Occurrence Handle8548896

    CAS  PubMed  Google Scholar 

  8. S Waxman MA Sassawer MA Mittleman S Zarich A Miyamoto KS Manzo JE Muller GS Abela RW Nesto (1996) ArticleTitleAngioscopic predictors of early adverse outcome after coronary angioplasty in patients with unstable angina and non-Q wave myocardial infarction Circulation 93 2106–2113 Occurrence Handle1:STN:280:BymB2M7ovVA%3D Occurrence Handle8925578

    CAS  PubMed  Google Scholar 

  9. AG Violaris R Melkert JP Hermann PW Serruys (1996) ArticleTitleRole of angiographically identifiable thrombus on long-term luminal renarrowing after coronary angioplasty. A quantitative angiographic analysis Circulation 93 889–897 Occurrence Handle1:STN:280:BymC2sbgtFw%3D Occurrence Handle8598079

    CAS  PubMed  Google Scholar 

  10. MM Khan SG Ellis FV Aguirre HF Weisman NM Wildermann RM Califf EJ Topol NS Kleiman (1998) ArticleTitleDoes intracoronary thrombus influence the outcome of high risk percutaneous transluminal coronary angioplasty? Clinical and angiographic outcomes in a large multicenter trial J Am Coll Cardiol 31 31–36 Occurrence Handle1:STN:280:DyaK1c%2FosF2rsQ%3D%3D Occurrence Handle9426014 Occurrence Handle10.1016/S0735-1097(97)00423-3

    Article  CAS  PubMed  Google Scholar 

  11. JW Moses I Moussa JJ Popma MHJ Sketch W Yeh (1999) ArticleTitleRisk of distal embolization after transluminal extraction atherectomy in diffusely diseasad saphenous vein grafts and native coronary arteries: NACI Investigators Catheter Cardiovasc Interv 47 149–154 Occurrence Handle1:STN:280:DyaK1Mzgt12rtA%3D%3D Occurrence Handle10376493 Occurrence Handle10.1002/(SICI)1522-726X(199906)47:2<149::AID-CCD3>3.0.CO;2-Z

    Article  CAS  PubMed  Google Scholar 

  12. InstitutionalAuthorNameThe TIMI Study Grroup (1985) ArticleTitleThe Thrombolysis in Myocardial Infarction (TIMI) trial N Engl J Med 31 932–936

    Google Scholar 

  13. MJ Claeys J Bosmans L Veenstra P Jorens H De Raedt CJ Vrints (1999) ArticleTitleDeterminants and prognostic implications of persistent ST-segment elevation after primary angioplasty for acute myocardial infarction: importance of microvascular reperfusion injury on clinical outcome Circulation 99 1972–1977 Occurrence Handle1:STN:280:DyaK1M3isFequw%3D%3D Occurrence Handle10209000

    CAS  PubMed  Google Scholar 

  14. S Matetzky M Novikov L Gruberg D Freimark M Feinberg D Elian I Novikov E Di Segni O Agranat Y Har-Zahav B Rabinowitz E Kaplinsky H Hod (1999) ArticleTitleThe significance of persistent ST-elevation versus early resolution of ST-segment elevation after primary PTCA J Am Coll Cardiol 34 1932–1938 Occurrence Handle1:STN:280:DC%2BD3c%2FltlChtQ%3D%3D Occurrence Handle10588206 Occurrence Handle10.1016/S0735-1097(99)00466-0

    Article  CAS  PubMed  Google Scholar 

  15. V van Ommen R Michels E Heymen J van Asseldonk H Bonnier J Vainer H de Swart J Koolen (2001) ArticleTitleUsefulness of the rescue PT catheter to remove fresh thrombus from coronary arteries and bypass grafts in acute myocardial infarction Am J Cardiol 88 306–308 Occurrence Handle10.1016/S0002-9149(01)01648-4 Occurrence Handle1:STN:280:DC%2BD3MvisVylsA%3D%3D Occurrence Handle11472715

    Article  CAS  PubMed  Google Scholar 

  16. JD Lorin MC Liou SP Sedlis (2003) ArticleTitleRapid thrombectomy for treatment of macroembolization during percutaneous coronary intervention in the setting of acute myocardial infarction Catheter Cardiovasc Interv 59 219–222 Occurrence Handle12772245 Occurrence Handle10.1002/ccd.10448

    Article  PubMed  Google Scholar 

  17. RA Kloner CE Ganote RB Jennings (1974) ArticleTitleThe “no-flow” phenomenon after temporary coronary occlusion in the dog J Clin Invest 54 1496–1508 Occurrence Handle1:STN:280:CSqD28%2FmvVY%3D Occurrence Handle4140198 Occurrence Handle10.1172/JCI107898

    Article  CAS  PubMed  Google Scholar 

  18. J Kotani S Nanto GS Mintz M Kitakaza T Ohara T Morozumi S Nagata M Hori (2002) ArticleTitlePlaque gruel of atheromatous coronary lesion may contribute to the no-reflow phenomenon in patients with acute coronary syndrome Circulation 106 1672–1677 Occurrence Handle10.1161/01.CIR.0000030189.27175.4E Occurrence Handle12270861

    Article  PubMed  Google Scholar 

  19. E Eeckhout MJ Kern (2001) ArticleTitleThe coronary no-flow: a review of mechanisms and therapies Eur Heart J 22 729–739 Occurrence Handle10.1053/euhj.2000.2172 Occurrence Handle1:STN:280:DC%2BD3M3lt1CnsA%3D%3D Occurrence Handle11350105

    Article  CAS  PubMed  Google Scholar 

  20. A Tanaka T Kawarabayashi Y Nishibori T Sano Y Nishida D Fukuda K Shimada J Yoshikawa (2002) ArticleTitleNo-reflow phenomenon and lesion morphology in patients with acute myocardial infarction Circulation 105 2148–2152 Occurrence Handle10.1161/01.CIR.0000015697.59592.07 Occurrence Handle11994247

    Article  PubMed  Google Scholar 

  21. SH Rezkalla RA Kloner (2002) ArticleTitleNo-reflow phenomenon Circulation 105 656–662 Occurrence Handle10.1161/hc0502.102867 Occurrence Handle11827935

    Article  PubMed  Google Scholar 

  22. T Reffelmann RA Kloner (2002) ArticleTitleThe “no-reflow” phenomenon: basic science and clinical correlates Heart 87 162–168 Occurrence Handle11796561 Occurrence Handle10.1136/heart.87.2.162

    Article  PubMed  Google Scholar 

  23. AW van't Hof A Liem MJ de Boer F Zijlstra (1997) ArticleTitleClinical value of 12-lead electrocardiogram after successful reperfusion therapy for acute myocardial infarction Lancet 350 615–619 Occurrence Handle10.1016/S0140-6736(96)07120-6

    Article  Google Scholar 

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Authors and Affiliations

  1. Second Department of Internal Medicine, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan

    Jin Yokoyama, Motoi Kushibiki, Takayuki Fujiwara, Yujin Tamura, Naotaka Maeda, Takumi Higuma, Shingo Sasaki, Fuminobu Yoshimachi, Toshiro Matsunaga, Hiroyuki Hanada, Tomohiro Osanai & Ken Okumura

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  1. Jin Yokoyama
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  2. Motoi Kushibiki
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  3. Takayuki Fujiwara
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Correspondence to Jin Yokoyama.

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Yokoyama, J., Kushibiki, M., Fujiwara, T. et al. Feasibility and safety of thrombectomy with TVAC aspiration catheter system for patients with acute myocardial infarction. Heart Vessels 21, 1–7 (2006). https://doi.org/10.1007/s00380-005-0850-8

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  • DOI: https://doi.org/10.1007/s00380-005-0850-8

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