Yonsei Med J.  2007 Apr;48(2):261-269. 10.3349/ymj.2007.48.2.261.

Thrombosuction Utilizing an Export Aspiration Catheter during Primary Percutaneous Coronary Intervention in Acute Myocardial nfarction

• Kang WC
• Ahn TH
• Han SH
• Chung WJ
• Shin MS
• Koh KK
• Choi IS
• Shin EK

• KMID: 1779529
• DOI: http://doi.org/10.3349/ymj.2007.48.2.261

Abstract

PURPOSE
Effective myocardial reperfusion after primary PCI for an AMI in lesions with a thrombus is limited by distal embolization and the slow/no reflow phenomenon. We evaluated the efficacy of a thrombus reduction technique using an export aspiration catheter for thrombosuction during primary PCI. MATERIALS AND METHODS: We analyzed 62 patients with AMIs who underwent primary PCI and had a thrombi burden during thrombosuction using an EAC (EAC group; n=31) or without thrombosuction (control group; n=31). RESULTS: Thrombosuction with an EAC was performed safely in all the patients in EAC group without any complications. After the PCI, restoration to a TIMI flow grade 3 was significantly more frequent in the EAC group (26/31 vs. 20/31, p < 0.05). However, the TIMI perfusion grade did not differ between the two groups. Further, the corrected TIMI frame counts were lower in the EAC group (23.9 ± 15.1 vs. 34.8 ± 22.5, p < 0.05). Although there was no statistical significance, a greater incidence of distal embolization was observed in the control group (16.1%, 5/31) as compared to the EAC group (0/31) (p= 0.056). However, the incidence of major adverse cardiac events at 1 and 6 months did not differ between the two groups. CONCLUSION: For AMIs, thrombosuction with an EAC before or during PCI is a safe and potentially effective method for restoration of the coronary flow.

Keyword

Acute myocardial infarction; primary percutaneous coronary intervention; thrombosuction; export aspiration catheter

MeSH Terms

Treatment Outcome
Suction/instrumentation/methods
Myocardial Infarction/*therapy
Middle Aged
Male
Humans
Coronary Disease/epidemiology
Catheterization/instrumentation/methods
Angioplasty, Transluminal, Percutaneous Coronary/*instrumentation/*methods
Aged

Figure

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  Fig. 1 (A) An export aspiration catheter connected to a 20cc syringe. (B-D) An example of successful thrombosuction using an EAC. (B) Initial angiogram showing a total occlusion of the distal right coronary artery with thrombi. (C) After thrombosuction, the distal flow was restored to a TIMI grade 3. (D) Retrieved thrombotic material. TIMI, thrombolysis in myocardial infarction.

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  Fig. 2 After the PCI, the recovery rate to a TIMI grade 3 flow was higher in the EAC group than the control group. However, there was no difference between the two groups for the TIMI perfusion grade. PCI, percutaneous coronary intervention; EAC, export aspiration catheter; TIMI, thrombolysis in myocardial infarction; TMPG, TIMI perfusion grade.

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  Fig. 3 After the PCI, the corrected TIMI frame count was less in the EAC group than in the control group. PCI, percutaneous coronary intervention; EAC, export aspiration catheter; corrected TFC, corrected TIMI frame count.

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