A comparison of intracoronary treatment strategies for thrombus burden removal during primary percutaneous coronary intervention: a COCTAIL II substudy

Coronary Artery Disease
Laura GattoFrancesco Prati

Abstract

Manual thrombus aspiration and local drug delivery of abciximab have been proposed as a strategy to reduce thrombus burden during percutaneous coronary intervention in patients with ST elevation myocardial infarction; however, the effectiveness of these approaches, is uncertain. In this COCTAIL II substudy, we compared the effect of these strategies on prestenting and poststenting thrombus burden assessed by optical coherence tomography. COCTAIL II trial enrolled patients with ST elevation myocardial infarction randomized to intralesion (IL, by the ClearWay catheter) versus intracoronary (IC, by the guide catheter) abciximab bolus with or without aspiration thrombectomy (AT). The following parameters were used to quantify atherothrombotic burden: thrombus volume (TVol), maximum thrombus area (TA), and thrombus burden (TB). Primary endpoint was the comparison of prestenting TVol after the use of local drug delivery (group IL+IL abciximab plus AT) versus nonlocal drug delivery (group IC abciximab plus AT+IC). The final population consisted of 59 patients undergoing both prestenting and poststenting optical coherence tomography assessment. The amount of thrombus was not significantly different in the groups with local drug deliver...Continue Reading

References

Feb 8, 2008·The New England Journal of Medicine·Tone SvilaasFelix Zijlstra
Nov 1, 2007·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Francesco PratiMario Albertucci
Sep 21, 2010·JACC. Cardiovascular Interventions·Francesco PratiCorrado Tamburino
Mar 27, 2012·JAMA : the Journal of the American Medical Association·Gregg W StoneUNKNOWN INFUSE-AMI Investigators
Aug 28, 2012·European Heart Journal·UNKNOWN Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC)Doron Zahger
Sep 3, 2013·The New England Journal of Medicine·Ole FröbertUNKNOWN TASTE Trial
Sep 23, 2014·European Heart Journal Cardiovascular Imaging·Olli A KajanderUNKNOWN TOTAL-OCT Substudy Investigators
Oct 15, 2014·Nature Reviews. Cardiology·Paolo G CamiciOrnella Rimoldi
Apr 9, 2015·The New England Journal of Medicine·Sanjit S JollyUNKNOWN TOTAL Investigators

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