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coronary thrombectomy

Istvan Hizoh, Gyongyver Banhegyi, Dominika Domokos, Zalan Gulyas, Laszlo Major, Robert Gabor Kiss
Although routine aspiration thrombectomy (AT) is not recommended by the current American College of Cardiology/American Heart Association/Society for Cardiovascular Angiography and Interventions guideline, for selected cases, a class IIb indication is given because of lack of data. We studied the impact of selective AT on mortality in patients with ST-segment elevation myocardial infarction using a prospective registry. We analyzed data of 1,255 patients, of whom 535 underwent AT based on operator's decision...
January 10, 2018: American Journal of Cardiology
Vincent Gautheron, Yu Xie, Marie Tisserand, Hélène Raoult, Sébastien Soize, Olivier Naggara, Romain Bourcier, Sébastien Richard, Francis Guillemin, Serge Bracard, Catherine Oppenheim
BACKGROUND AND PURPOSE: Stroke patients with large diffusion-weighted imaging (DWI) volumes are often excluded from reperfusion because of reckoned futility. In those with DWIvolume >70 mL, included in the THRACE trial (Mechanical Thrombectomy After Intravenous Alteplase Versus Alteplase Alone After Stroke), we report the associations between baseline parameters and outcome. METHODS: We examined 304 patients with anterior circulation stroke and pretreatment magnetic resonance imaging...
March 2018: Stroke; a Journal of Cerebral Circulation
Katarzyna Pigoń, Edyta Nowak-Radzik, Tomasz Młyńczak, Grzegorz Banasik, Ewa Nowalany-Kozielska, Andrzej Tomasik
AIM: Study was aimed to assess the real-world costs of manual thrombectomy (MT) in selected ST segment-elevation myocardial infarction patients with intracoronary thrombus (IT). METHODS: Study group (IT+) comprised 51 patients with MT applied and control group (IT-) comprised 56 patients without IT who underwent angioplasty alone. Costs comprised hospital care and cost of disposable materials used during primary angioplasty. RESULTS: Complex management of patients with IT is more expensive, though allows to achieve clinical outcomes comparable to low-risk ST segment-elevation myocardial infarction patients without IT...
January 29, 2018: Journal of Comparative Effectiveness Research
Shih-Wei Meng, Ruei-Cheng Kuo, Hui-Jen Yang, Chao-Lun Lai, Chih-Cheng Wu, Mu-Yang Hsieh
Stroke treatment has entered a new era after the publication of multiple randomized trials involving the use of a stent retriever since 2015. In Taiwan, the demand for interventional neuroradiologists to perform mechanical thrombectomy is high. For this reason, providing this standard care requires reshaping of the care model. Here, we report our experience in recruiting an acute coronary care team to perform emergent mechanical thrombectomy, which is essential in a patient with acute ischemic stroke.
January 2018: Acta Cardiologica Sinica
Albert Pall Sigurdsson
This article discusses endovascular thrombectomy in acute ischemic stroke. This treatment is vascular medicine's most significant leap in years. This treatment is complicated, and various technical aspects are discussed. Close cooperation is required between different specialties since patient selection for treatment is complex. Interventionists need close collaboration with stroke neurologists. Government needs to be involved as this treatment mandates structural changes which will incur more manpower and financial resources...
January 2018: Læknablađiđ
Antonis S Manolis
BACKGROUND: Intracoronary thrombus in acute myocardial infarction (MI) confers higher rates of no-reflow with attendant adverse consequences. Earlier randomized-controlled-trials (RCTs) of routine thromboaspiration during percutaneous coronary intervention (PCI) indicated a clinical benefit, but more recent RCTs were negative. However, data of selective use of this adjunctive approach remain scarce. OBJECTIVE: The aim of this single-centre prospective study was to report the results of selective thromboaspiration during PCI in patients with intracoronary thrombi, and also to provide an extensive literature review on current status of thromboaspiration...
January 1, 2018: Current Vascular Pharmacology
Mohammad K Mojadidi, Ahmed N Mahmoud, Akram Y Elgendy, R David Anderson
Ventricular arrhythmia from aortic cusp thrombosis and coronary embolization is a rare complication of left ventricular assist device (LVAD) implantation. In this report, we present a case of acute left main and left anterior descending artery occlusion from embolic aortic cusp thrombi after LVAD implant. The patient presented with chest pain and incessant ventricular tachycardia post-LVAD implant. This was successfully treated by intracoronary thrombolysis, aspiration thrombectomy, and rheolytic thrombectomy...
October 21, 2017: Curēus
Shinichiro Masuda, Takashi Shibui, Ryuki Kawamura, Hitoshi Saiki, Akihiro Hata
A 43-year-old man was admitted to our hospital with ST-segment elevation acute coronary syndrome. He had experienced myocardial infarction 19 months previously, and a bare-metal stent (BMS) had been implanted in the culprit distal right coronary artery at another hospital. Emergency coronary angiography showed thrombotic in-stent occlusion of the BMS. Intravascular ultrasound revealed an undersized stent compared with the size of the vessel and late stent malapposition (LSM) with abundant thrombi. The lesion was successfully recanalized via thrombectomy and plain old balloon angioplasty...
December 27, 2017: International Heart Journal
Guy Achkouty, Jean-Guillaume Dillinger, Georgios Sideris, Stephane Manzo-Silberman, Sebastian Voicu, Benoit Merat, Damien Logeart, Patrick Henry
BACKGROUND: Direct stenting is the best method for achieving reperfusion in primary percutaneous coronary intervention (PPCI). We hypothesized that the use of a microcatheter (MC) during PPCI when Thrombolysis in Myocardial Infarction (TIMI) flow ≤ 1 after wire crossing would allow visualization of the downstream artery with an optimal TIMI 3 flow at the end of the procedure. METHODS: In this pilot study, PPCI patients with TIMI flow ≤ 1 after wire crossing formed the MC group (n = 60); the MC was positioned in the distal part of the culprit artery and a small amount of contrast was injected through it to determine stent size and length to treat the culprit lesion...
January 2018: Canadian Journal of Cardiology
J M Arribas, E Garcia, R Jara, F Gutierrez, L Albert, D Bixquert, J García-Puente, C Albacete, S Canovas, A Morales
OBJECTIVE: We studied patients who had experienced a stroke in the postoperative period of cardiac surgery, aiming to analyse their progression and determine the factors that may influence prognosis and treatment. METHODS: We established a protocol for early detection of stroke after cardiac surgery and collected data on stroke onset and a number of clinical, surgical, and prognostic variables in order to perform a descriptive analysis. RESULTS: Over the 15-month study period we recorded 16 strokes, which represent 2...
December 14, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Seraj A Abualnaja, Hanan M Alrammah, Bayan A Alsaif, Malak O Almulla, Bayan A Alzahrani
BACKGROUND The introduction of bioresorbable vascular scaffolds (BVS) into the field of percutaneous coronary intervention (PCI) was thought to be a promising step in solving the issues raised with the use of early bare metal stents (BMS) and drug eluting stents (DES); however, studies have raised concerns regarding thrombosis risk associated with the use of these stents. CASE REPORT A 42-year-old male presented with acute coronary syndrome (ACS), on diagnostic coronary angiography he had 75% and 70% stenosis in mid and distal left anterior descending artery (LAD) respectively, PCI with BVS implantation was done...
December 16, 2017: American Journal of Case Reports
Xiao-Wei Niu, Jing-Jing Zhang, Ming Bai, Yu Peng, Zheng Zhang
Background: Suboptimal myocardial reperfusion is common in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Furthermore, it results in increased infarct size and mortality rates. We performed a meta-analysis to evaluate the role of aspiration thrombectomy (AT) combined with intracoronary administration of glycoprotein IIb/IIIa inhibitors (GPI) in the improvement of myocardial reperfusion and clinical outcomes...
October 2017: Journal of Geriatric Cardiology: JGC
Stephanie Perrier, Alice Parker, Christian P Brizard, Bennett Sheridan, Igor E Konstantinov, Yves d'Udekem, Johann Brink
Extensive perinatal myocardial infarction caused by coronary artery thrombosis is extremely rare and has a dismal prognosis. We report a 3.5-kg neonate who presented at birth with an extensive myocardial infarction caused by aortic root and left main coronary artery thrombus after an emergency cesarean section. We performed emergency surgical thrombectomy and insertion of extracorporeal membrane oxygenation support. After subsequent conversion to long-term left ventricular assist device with an EXCOR device (Berlin Heart, Berlin, Germany), the patient had no ventricular recovery after 163 days of support...
December 2017: Annals of Thoracic Surgery
Sebastian Bellwald, Ralph Weber, Tomas Dobrocky, Hannes Nordmeyer, Simon Jung, Jeffrie Hadisurya, Pasquale Mordasini, Marie-Luise Mono, Christian P Stracke, Hakan Sarikaya, Corrado Bernasconi, Klaus Berger, Marcel Arnold, René Chapot, Jan Gralla, Urs Fischer
BACKGROUND AND PURPOSE: Randomized controlled trials have shown that mechanical thrombectomy (MT) plus best medical treatment improves outcome in stroke patients with large-vessel occlusion in the anterior circulation. Whether direct MT is equally effective as bridging thrombolysis (intravenous thrombolysis plus MT) in intravenous thrombolysis eligible patients remains unclear. METHODS: We compared clinical and radiological outcomes at 3 months in 249 bridging patients with 111 patients receiving direct MT for large-vessel occlusion anterior circulation stroke from 2 prospective registries (study period Essen: June 2012 to August 2013, Bern February 2009 to August 2014)...
December 2017: Stroke; a Journal of Cerebral Circulation
Neeraj Parakh, Basavaraj Utagi, Sudhir Arava, Sunil Verma, Ganesan Karthikeyan, Sandeep Singh, Balram Bhargava, Ruma Ray, Chetan D Patel, Vinay K Bahl
BACKGROUND: Manual thrombus aspiration during primary percutaneous intervention provides us with aspirated thrombus sample, that may contain material from the disrupted plaque. Immunohistopathological analysis of thrombus can yield valuable information about the clinical and cardiovascular outcomes and possible mechanisms of myocardial infarction. MATERIAL AND METHODS: We studied and analysed the immunohistopathological features of coronary thrombus aspirated from patients undergoing primary percutaneous coronary angioplasty...
September 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
R Cheaito, A Tritar, H Benamer, M Saighi Bouaouina, A Masri, M A Bouzid, M Younes, H Mansour, P Jessen
The pheochromocytome is a localized tumor at the level of the medullosurrenale in 85% of the cases. The clinical presentation is very variable. Severe Heart failure presentation can be the mode of revelation in 2% of the cases. We present the case of a patient admitted for refractory cardiogenic shock correlated to pheochromocytome tumor. The difficulty of this rare clinical presentation was to confirm rapidly and in emergency this diagnosis in the same time when the patient presents a persistante and severe cardiogenic chock after finding a sub-occluded and thrombotic LAD coronary artery and which was treated by thrombectomy and coronary revascularization...
November 2, 2017: Annales de Cardiologie et D'angéiologie
Laura Gatto, Alessio Di Landro, Enrico Romagnoli, Valeria Marco, Chiara Russo, Tomasz Pawlowski, Francesco Versaci, Ugo Limbruno, Fausto Castriota, Luca Di Vito, Antonio Trivisonno, Francesco Prati
BACKGROUND: 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. PATIENTS AND METHODS: 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)...
October 27, 2017: Coronary Artery Disease
Junhua Ge, Andreas Schäfer, Georg Ertl, Peter Nordbeck
The role of manual thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) for acute ST-segment-elevation myocardial infarction has been a matter of intense research and debate now. Although recent randomized controlled clinical trials (notably TASTE [Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia] and TOTAL [Trial of Routine Aspiration Thrombectomy With PCI Versus PCI Alone in Patients With STEMI]) do not supply evidence supporting the routine use of TA in patients with ST-segment-elevation myocardial infarction, manual TA remains a therapeutic option for interventional cardiologists when treating patients with substantial thrombus burden during PPCI...
October 2017: Circulation. Cardiovascular Interventions
Alireza Khosravi, Davoud Rajabi, Masoud Pourmoghaddas, Afzal Roohi, Masoumeh Esmaeili
BACKGROUND: The applicability of manual aspiration thrombectomy in patients with ST-segment elevation myocardial infarction (STEMI) has been a challenging issue. This study aimed to compare the impact of additive manual thrombectomy on patients with myocardial infarction (MI) and total cutoff vessel with standard primary percutaneous coronary intervention (PPCI) with bailout thrombectomy. METHODS: In this case-control study, 181 patients with acute STEMI were enrolled who referred to Chamran Hospital (Isfahan, Iran) between August to December 2014...
March 2017: ARYA Atherosclerosis
Fahad Alqahtani, Sami Aljohani, Abdul Tarabishy, Tatiana Busu, Amelia Adcock, Mohamad Alkhouli
BACKGROUND AND PURPOSE: Data on the incidence and outcomes of acute myocardial infarction (AMI) complicating acute ischemic stroke (AIS) are limited. We aim to evaluate the incidence, treatment patterns, and outcomes of AMI in patients with AIS using a nationwide database. METHODS: The National Inpatient Sample was used to identify patient with AIS between 2003 and 2014. Trends of incidence of AMI and its associated in-hospital mortality were evaluated. Univariate and multivariate logistic regressions were used to evaluate predictors of AMI...
November 2017: Stroke; a Journal of Cerebral Circulation
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