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Thrombus aspiration , myocardial infarction

Kriton-Ioannis Roukas, Konstantinos Lampropoulos, Anastasios Salachas
No abstract text is available yet for this article.
September 2016: Indian Heart Journal
Ana Blasco, Carmen Bellas, Leyre Goicolea, Ana Muñiz, Víctor Abraira, Ana Royuela, Susana Mingo, Juan Francisco Oteo, Arturo García-Touchard, Francisco Javier Goicolea
INTRODUCTION AND OBJECTIVES: Thrombus aspiration allows analysis of intracoronary material in patients with ST-segment elevation myocardial infarction. Our objective was to characterize this material by immunohistology and to study its possible association with patient progress. METHODS: This study analyzed a prospective cohort of 142 patients undergoing primary angioplasty with positive coronary aspiration. Histological examination of aspirated samples included immunohistochemistry stains for the detection of plaque fragments...
October 10, 2016: Revista Española de Cardiología
Takumi Higuma, Tsunenari Soeda, Masahiro Yamada, Takashi Yokota, Hiroaki Yokoyama, Kei Izumiyama, Fumie Nishizaki, Yoshiyasu Minami, Lei Xing, Erika Yamamoto, Hang Lee, Ken Okumura, Ik-Kyung Jang
OBJECTIVES: The aim of this study was to evaluate if residual thrombus burden after aspiration thrombectomy affects the outcomes of primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Recent studies failed to show clinical benefit of aspiration thrombectomy in STEMI patients. This might be due to insufficient removal of thrombus at the culprit lesion. METHODS: A total of 109 STEMI patients who underwent aspiration thrombectomy followed by stenting within 24 h from symptom onset were included...
October 10, 2016: JACC. Cardiovascular Interventions
B Ajlani, G Gibault-Genty, G Cherif, E Blicq, S Azzaz, P Schiano, M Brami, L Sarfati, C Charbonnel, R Convers-Domart, B Livarek, J-L Georges
BACKGROUND: Massive intracoronary thrombus is associated with adverse procedural results including failed aspiration and unfavourable reperfusion. We aim to evaluate the effect of the intracoronary administration of antithrombotic agents via a perfusion catheter in patients with ST-segment elevation myocardial infarction (STEMI) presenting with a large thrombus burden and failed aspiration. METHODS: We retrospectively analyzed the thrombus burden, the TIMI grade flow, and the myocardial Blush in 25 consecutive STEMI patients with a large thrombus burden and failed manual aspiration, who received intracoronary infusion of glycoprotein IIb/IIIa inhibitors (N=17) or bivalirudine (N=8) via a 6F-infusion catheter (ClearWay™ RX) RESULTS: Mean age was 67±14 years, 16 patients (64 %) presented with anterior STEMI, and 7 (28 %) with cardiogenic shock...
September 29, 2016: Annales de Cardiologie et D'angéiologie
Ashleigh Dind, Usaid Allahwala, Kaleab N Asrress, Sanjit S Jolly, Ravinay Bhindi
Recent advances have caused a major shift in the way ST-elevation myocardial infarctions are managed. This review explores the pharmacological and interventional techniques that have evidence for improving outcomes and the landmark trials that have sparked change. The new P2Y12 inhibitors, ticagrelor and prasugrel, have been shown to be superior to clopidogrel in STEMI patients undergoing primary percutaneous coronary intervention. Concurrently, many technical aspects of percutaneous coronary intervention have been further clarified by trial data, with bare-metal stents, routine thrombus aspiration and femoral access showing evidence of inferiority...
August 22, 2016: Heart, Lung & Circulation
Kavita Krishna, Shirish Hiremath, Sachin Lakade, Sudarshan Davakhar
A 28 year old male, known case of nephrotic syndrome since 12 years, hypertensive presented with acute myocardial infarction (AMI) and accelerated hypertension. Coronary angiography revealed 100% thrombotic occlusion of mid left anterior descending artery, treated with thrombus aspiration and intracoronary tirofiban and nitroglycerine. He was stabilized within 24 hours. The pathogenesis of AMI in nephrotic syndrome has been discussed with this case report.
November 2015: Journal of the Association of Physicians of India
Kevin Kris Warnakula Olesen, Trine Ørhøj Barkholt, Michael Maeng
PURPOSE: Coronary angiography provides no details on underlying pathology in acute coronary syndromes (ACS). Optical coherence tomography (OCT) can visualize coronary atherosclerosis, thrombus formation, and plaque rupture in patients with myocardial infarction (MI) where coronary angiography is unclear. MATERIALS AND METHODS: We present a case series containing 6 young patients with ACS, 4 of them due to non-obstructive thrombus, in whom the operators refrained from stent implantation despite an identifiable culprit lesion with OCT-validated thrombus formation...
September 5, 2016: Scandinavian Cardiovascular Journal: SCJ
Haibo Jia, Jiannan Dai, Jingbo Hou, Lei Xing, Lijia Ma, Huimin Liu, Maoen Xu, Yuan Yao, Sining Hu, Erika Yamamoto, Hang Lee, Shaosong Zhang, Bo Yu, Ik-Kyung Jang
AIMS: Plaque erosion, compared with plaque rupture, has distinctly different underlying pathology and therefore may merit tailored therapy. In this study, we aimed to assess whether patients with acute coronary syndrome (ACS) caused by plaque erosion might be stabilized by anti-thrombotic therapy without stent implantation. METHODS AND RESULTS: This was a single-centre, uncontrolled, prospective, proof-of concept study. Patients with ACS including ST-segment elevation myocardial infarction were prospectively enrolled...
August 30, 2016: European Heart Journal
Ashwad Afzal, Bimal Patel, Neel Patel, Sudhakar Sattur, Vinod Patel
Clopidogrel resistance from CYP2C19 polymorphism has been associated with stent thrombosis in patients undergoing percutaneous coronary intervention with drug-eluting stents. We present a case of a 76-year-old male who received drug-eluting stents to the right coronary artery and left anterior descending artery for non-ST elevation myocardial infarction and was discharged on dual antiplatelet therapy with aspirin and clopidogrel. He subsequently presented with chest pain from anterior, anteroseptal, and inferior ST segment elevation myocardial infarction...
2016: Case Reports in Medicine
Alberto Dominguez-Rodriguez, Pedro Abreu-Gonzalez, Luciano Consuegra-Sanchez, Pablo Avanzas, Alejandro Sanchez-Grande, Pablo Conesa-Zamora
Recent studies have demonstrated that inflammatory cells are a component that plays a role in thrombus formation in ST-elevation myocardial infarction (STEMI). 3-nitrotyrosine (3-NO2-Tyr), a specific marker for protein modification by nitric oxide-derived oxidants, is increased in human atherosclerotic lesions. The purpose of this study was to determine the possible association of inflammatory markers of coronary thrombi with nitroxidative stress. Intracoronary thrombus (n=51) and blood from the systemic circulation were obtained by thromboaspiration in 138 consecutive STEMI patients presenting for primary percutaneous coronary intervention (PCI)...
2016: International Journal of Medical Sciences
Carlijn G Maagdenberg, Onno J de Boer, Xiaofei Li, Claire Mackaay, Hans W Niessen, Robbert J de Winter, Allard C Van der Wal
AIM: To study the rate of apoptotic cell death in the process of thrombus evolution after plaque rupture in myocardial infarction. METHODS: Paraffin embedded thrombosuction aspirates of 63 patients were stained with haematoxylin & eosin (H&E) to assess histologically the age of the thrombi: fresh (intact blood cells; <1day old), lytic (necrosis; 1-5days old) or organized (ingrowth of cells; >5days old). Presence of plaque constituents (atheroma including foam cells, cholesterol crystals calcifications and fibrous cap tissue) was also recorded...
September 2016: Thrombosis Research
Yan Zhang, Li Peng, Yong-Yan Fan, Cai-Yi Lu
BACKGROUND: The clinical efficacy and safety of adjunctive thrombus aspiration (TA) in patients with ST-segment elevation myocardial infarction (STEMI) during percutaneous coronary intervention (PCI) remain controversial. METHODS: Twenty five eligible randomized controlled trials were included to compare the use of thrombus aspiration (TA) with PCI and PCI-only for STEMI. The primary endpoint was all-cause mortality and death. The secondary endpoints were major adverse cardiac events (MACE), recurrent infarction (RI), target vessel revascularization (TVR), stent thrombosis (ST), perfusion surrogate markers and stroke...
May 2016: Journal of Geriatric Cardiology: JGC
Roberto Diletti, Jors van der Sijde, Antonios Karanasos, Jiang Ming Fam, Cordula Felix, Nicolas M van Mieghem, Evelyn Regar, Richard Rapoza, Felix Zijlstra, Robert Jan van Geuns
BACKGROUND: The hypothesized increased thrombus entrapment during bioresorbable vascular scaffold implantation in acute myocardial infarction, the so-called "snowshoe effect" has never been demonstrated. METHODS: Patients enrolled in the BVS STEMI FIRST study matched with STEMI patients implanted with everolimus-eluting metal stents (EES) and undergoing optical coherence tomography (OCT) at the index procedure were compared. Quantitative coronary angiography analysis and optical coherence tomography data for evaluation of thrombotic prolapse were reported...
October 1, 2016: International Journal of Cardiology
Daniel Rios P Ribeiro, Eduardo Cambruzzi, Marcia Moura Schmidt, Alexandre S Quadros
In patients with ST-elevation myocardial infarction, recurrent cardiovascular events still remain the main cause of morbidity and mortality, despite significant improvements in antithrombotic therapy. We sought to review data regarding coronary thrombus analysis provided by studies using manual aspiration thrombectomy (AT), and to discuss how insights from this line of investigation could further improve management of acute coronary disease. Several studies investigated the fresh specimens retrieved by AT using techniques such as traditional morphological evaluation, optical microscopy, scanning electron microscopy, magnetic resonance imaging, and immunohistochemistry...
June 26, 2016: World Journal of Cardiology
Paul Russhard, Firas Al Janabi, Michael Parker, Gerald J Clesham
BACKGROUND: ST segment elevation allows the rapid identification of patients with acute myocardial infarction who benefit from emergency reperfusion. Primary percutaneous coronary intervention (PPCI) has emerged as the preferred perfusion strategy for patients presenting with ST segment elevation myocardial infarction (STEMI). METHODS AND RESULTS: We studied the effects of the simple passage of an angioplasty guidewire followed by mechanical thrombus aspiration on the ST segment displacement in 289 patients presenting with acute STEMI...
2016: Open Heart
Ivan Ilić, Ivan Stanković, Radosav Vidaković, Aleksandra Janićijević, Milivoje Cerović, Vladimir Jovanović, Aleksandar Aleksić, Gojko Obradović, Ivica Nikolajević, Srdjan Kafedzić, Dusan Milicević, Jovana Kusić, Biljana Putniković, Aleksandar N Nesković
INTRODUCTION: Data on effects of thrombus aspiration on left ventricular diastolic function in ST-elevation myocardial infarction (STEMI) population are scarce. OBJECTIVE: We sought to compare echocardiographic indices of the diastolic function and outcomes in STEMI patients treated with and without manual thrombus aspiration, in an academic, high-volume percutaneous coronary intervention (PCI) center. METHODS: A total of 433 consecutive patients who underwent primary PCI in 2011-2012 were enrolled in the study...
January 2016: Srpski Arhiv za Celokupno Lekarstvo
Abdullah M Al-Alawi, Jyotsna Janardan, Kah Y Peck, Alan Soward
A myocardial infarction is a rare complication which can occur after an exercise stress test. We report a 48-year-old male who was referred to the Mildura Cardiology Practice, Victoria, Australia, in August 2014 with left-sided chest pain. He underwent an exercise stress test which was negative for myocardial ischaemia. However, the patient presented to the Emergency Department of the Mildura Base Hospital 30 minutes after the test with severe retrosternal chest pain. An acute anteroseptal ST segment elevation myocardial infarction was observed on electrocardiography...
May 2016: Sultan Qaboos University Medical Journal
T Geng, J-G Zhang, Z-Y Song, S-P Dai, Y Luo, Z-S Xu
AIM: Primary percutaneous coronary intervention is the most effective treatment for patients with ST-segment elevation myocardial infarction (STEMI). This study aimed to investigate whether the combination of aspiration thrombectomy with intracoronary tirofiban treatment can result in smaller infarcts and better patient prognosis compared with aspiration thrombectomy alone. PATIENTS AND METHODS: In all, 150 patients with STEMI underwent primary percutaneous coronary intervention...
May 24, 2016: Herz
François Schiele, Fiona Ecarnot
BACKGROUND: Thrombectomy for the treatment of ST elevation myocardial infarction (STEMI) is a simple and intuitive idea. In the 2000s, several studies evaluated the efficacy of thrombus aspiration and showed that thrombus aspiration led to improved myocardial perfusion, as assessed by a range of surrogate endpoints. These findings were confirmed by meta-analyses. However, the favorable results with thrombo-aspiration in STEMI were subsequently called into question by data indicating not only a lack of efficacy, but a risk of potentially deleterious complications...
2016: BMC Cardiovascular Disorders
Ahmed Al Badri, Chad Kliger, Dillon Weiss, Luigi Pirelli, Sean Wilson, Edward R DeLaney, Vladimir Jelnin, Itzhak Kronzon, Gila Perk, Jonathan M Hemli, Nirav C Patel, Suhail Raoof, Carlos E Ruiz
BACKGROUND: Right heart thrombus in the absence of structural heart disease, atrial fibrillation, or intracardiac catheter is rare. It typically represents a thrombus migrating from the venous system to the lung, known as thrombi-in-transit, and can lead to a life-threatening pulmonary embolism. The optimal therapy for thrombi-in-transit remains controversial. We report our experience using percutaneous removal of right heart thrombus using vacuum aspiration. METHODS: Patients with right atrial mass who were hemodynamically stable and underwent vacuum thombectomy using the AngioVac system (AngioDynamics) at our institution were included in this analysis...
May 2016: Journal of Invasive Cardiology
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