Prospective study of extraction atherectomy in patients with acute myocardial infarction

The American Journal of Cardiology
B M KaplanC L Grines

Abstract

Although percutaneous transluminal coronary angioplasty (PTCA) has been an effective treatment for primary reperfusion in acute myocardial infarction, patients with thrombolytic ineligibility, thrombolytic failure, cardiogenic shock, and vein graft occlusion remain at high risk for complications with PTCA treatment. The transluminal extraction catheter may be useful for treatment for such patients owing to its ability to aspirate thrombus. At 2 clinical centers, extraction atherectomy was prospectively evaluated in 100 patients (age 62 +/- 10 years). High-risk features included thrombolytic failure in 40%, postinfarct angina in 28%, presence of angiographic thrombus in 66%, presence of cardiogenic shock in 11%, and a saphenous vein graft occlusion in 29%. Procedural success, defined as a final residual stenosis <50% and Thrombolysis in Myocardial Infarction 2 or 3 grade flow, was seen in 94%. Events during the hospitalization included death in 5%, bypass surgery in 4%, and blood transfusion in 18%. In a substudy, patients enrolled at William Beaumont Hospital (n = 65) underwent elective predischarge angiography, which revealed a patent infarct-related vessel in 95%. These patients were also followed for 6 months with angiograph...Continue Reading

References

Aug 27, 2003·Circulation Journal : Official Journal of the Japanese Circulation Society·Hitoshi AnzaiMasami Sakurada
Nov 10, 2004·Annales de cardiologie et d'angéiologie·A SudreJ M Lablanche
Apr 8, 1998·Journal of the American College of Cardiology·S B King
Oct 1, 1996·Catheterization and Cardiovascular Diagnosis·K H Benzuly, W W O'Neill

Citations

Dec 15, 1992·The American Journal of Cardiology·J J PopmaA D Pichard
Mar 1, 1992·Journal of the American College of Cardiology·S G EllisE J Topol
Oct 1, 1990·Journal of the American College of Cardiology·J G WebbS H Stertzer
Jun 15, 1994·The American Journal of Cardiology·S K AgrawalG S Roubin

Related Concepts

Suction Drainage
Coronary Restenosis
Arterial System
Target Vessel
Entire Vein
Transluminal Route of Drug Administration
Saphenous Vein
Myocardial Infarction
Coronary Thrombosis
Aspirate Substance

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