Urgent PCI in patients with stent thrombosis: an observational single-center study comparing thrombus aspiration and standard PCI

Stent thrombosis (ST) is a recognized complication of percutaneous coronary interventions (PCI). Due to the high thrombus burden present in ST, the use of thrombus aspiration (TA) may enhance the angiographic results by limiting distal embolization. Consecutive patients undergoing urgent PCI due to...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of invasive cardiology 2008-04, Vol.20 (4), p.161-165
Main Authors: De Vita, Maria, Burzotta, Francesco, Trani, Carlo, Romagnoli, Enrico, Talarico, Giovanni Paolo, Porto, Italo, Leone, Antonio Maria, Biondi-Zoccai, Giuseppe G L, Niccoli, Giampaolo, Rebuzzi, Antonio Giuseppe, Mongiardo, Rocco, Mazzari, Mario Attilio, Schiavoni, Giovanni, Crea, Filippo
Format: Article
Language:English
Subjects:
Aged
Angioplasty, Balloon, Coronary - instrumentation
Angioplasty, Balloon, Coronary - methods
Anticoagulants - therapeutic use
Coronary Angiography
Coronary Thrombosis - etiology
Coronary Thrombosis - prevention & control
Female
Heparin - therapeutic use
Humans
Male
Middle Aged
Stents
Thrombectomy
Time Factors
Treatment Outcome
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Stent thrombosis (ST) is a recognized complication of percutaneous coronary interventions (PCI). Due to the high thrombus burden present in ST, the use of thrombus aspiration (TA) may enhance the angiographic results by limiting distal embolization. Consecutive patients undergoing urgent PCI due to ST were studied, consisting of two groups according to the type of intervention (standard PCI [SP] or TA). TIMI flow, corrected TIMI frame count (cTFC), myocardial blush grade (MBG), thrombus score (TS), Yip's adverse thrombus burden features, occurrence of angiographically evident distal embolization (DE) were evaluated offline. In-hospital outcomes were also recorded. Twenty-eight patients entered the study. Baseline clinical and angiographic features were similar between patients treated by SP (n = 12) and those treated by TA (n = 16). After PCI, a trend in favor of TA as compared to SP was observed for post-PCI TIMI 3 flow rate (67% vs. 89%; p = 0.10), final cTFC (31 +/- 35 vs. 17 +/- 21; p = 0.10) and MBG 2-3 rate (40% vs. 67%; p = 0.12). Accordingly, the rate of adverse angiographic outcome (post-PCI TIMI 0-1 flow and/or DE) was significantly lower in the TA as compared to SP: 5% (1 out of 18) vs. 33% (5 out of 15) respectively (p = 0.04). Throughout hospitalization, major adverse events occurred in 6% of TA patients vs. 33% of SP patients (p = 0.08). TA in patients with ST is safe and is associated with better angiographic outcomes compared to standard PCI. Larger studies are warranted to confirm these early observations.
ISSN:1557-2501