PMID- 17300401
OWN - NLM
STAT- MEDLINE
DCOM- 20070322
LR  - 20161124
IS  - 0896-4327 (Print)
IS  - 0896-4327 (Linking)
VI  - 20
IP  - 1
DP  - 2007 Feb
TI  - Thrombus aspiration with export catheter in ST elevation myocardial infarction.
PG  - 38-43
AB  - BACKGROUND: Many thrombectomy devices have failed to confirm initial promising 
      results during primary angioplasty. This may be due to device complexity and 
      operator experience. The objective of this study was to assess the safety and 
      efficacy of the EXPORT catheter for thrombus aspiration in patients with ST 
      elevation myocardial infarction (STEMI). METHODS: EXPORT catheter was used in 
      patients with STEMI and angiographic evidence of thrombus in vessels with a 
      reference diameter > or =1.5 mm. Direct stenting and glycoprotein IIb/IIIa 
      inhibitors were liberally employed to optimize angiographic and clinical results. 
      Epicardial and myocardial angiographic parameters, in-hospital major adverse 
      cardiac events (MACE, i.e., cardiac death, myocardial infarction, target vessel 
      revascularization) were assessed. RESULTS: EXPORT catheter was used in 129 
      patients without any device-related complications. Angiographic analysis 
      following thrombus aspiration revealed a significant improvement in TIMI frame 
      count (P = 0.0001), myocardial perfusion (P = 0.0001), TIMI thrombus grade (P = 
      0.0001), and TIMI flow (P = 0.0001). Stent implantation did not significantly 
      improve myocardial perfusion, TIMI thrombus grade, or TIMI flow, but improved 
      TIMI frame count, minimal lumen, and reference vessel diameter. When compared to 
      a historical STEMI control group not undergoing thrombus aspiration, our EXPORT 
      population showed significant improvements in reperfusion parameters. In-hospital 
      MACE were uncommon (4.5%) despite high-risk patient characteristics. CONCLUSIONS: 
      Our study demonstrates that routine use of EXPORT catheter in patients with STEMI 
      and coronary thrombosis is feasible, safe, and associated with significant 
      improvements in flow-related angiographic parameters. The relative simplicity of 
      this approach makes it an attractive option in this challenging situation.
FAU - Margheri, Massimo
AU  - Margheri M
AD  - Dipartimento del Cuore e dei Vasi, Azienda Ospedaliero-Universitaria Careggi, 
      Florence, Italy. cardioinvasiva2@ao-careggi.toscana.it
FAU - Vittori, Guido
AU  - Vittori G
FAU - Chechi, Tania
AU  - Chechi T
FAU - Falchetti, Elena
AU  - Falchetti E
FAU - Cosgrave, John
AU  - Cosgrave J
FAU - Spaziani, Gaia
AU  - Spaziani G
FAU - Ricceri, Ilaria
AU  - Ricceri I
FAU - Giglioli, Christina
AU  - Giglioli C
FAU - Valente, Serafina
AU  - Valente S
FAU - Gensini, Gian Franco
AU  - Gensini GF
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Interv Cardiol
JT  - Journal of interventional cardiology
JID - 8907826
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
SB  - IM
MH  - Aged
MH  - Cardiac Catheterization/*instrumentation
MH  - Coronary Angiography
MH  - Coronary Thrombosis/diagnostic imaging/pathology/physiopathology/*surgery
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnostic imaging/pathology/physiopathology/*surgery
MH  - Myocardial Reperfusion
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/administration & dosage
MH  - Severity of Illness Index
MH  - *Stents
MH  - Thrombectomy/*instrumentation
MH  - Treatment Outcome
EDAT- 2007/02/16 09:00
MHDA- 2007/03/23 09:00
CRDT- 2007/02/16 09:00
PHST- 2007/02/16 09:00 [pubmed]
PHST- 2007/03/23 09:00 [medline]
PHST- 2007/02/16 09:00 [entrez]
AID - JOIC221 [pii]
AID - 10.1111/j.1540-8183.2007.00221.x [doi]
PST - ppublish
SO  - J Interv Cardiol. 2007 Feb;20(1):38-43. doi: 10.1111/j.1540-8183.2007.00221.x.