Comparison of the Reperfusion Efficacy of Thrombus Aspiration With and Without Distal Protection During Primary Percutaneous Coronary Intervention in Patients With Acute ST-Segment Elevation Myocardial Infarction

Satoh, Shuichi; Inoue, Hiroko; Omura, Soichiro; Ejima, Emiko; Shimozono, Koutastu; Hayashi, Makiko; Mori, Takahiro; Takenaka, Katsuto; Kawamura, Natsumi; Numaguchi, Kotaro; Mori, Etsuo; Asoh, Akemi; Nakamura, Toshihiro; Hiyamuta, Kohji

doi:10.1016/j.amjcard.2013.07.039

Cited by 6 publications

(2 citation statements)

References 21 publications

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“…This procedural strategy was adopted because past studies [ 5 , 6 ] have indicated that, when compared with standard balloon predilatation, routine thrombus aspiration for ST elevation myocardial infarction (STEMI) does not reduce prestent thrombus burden and fails to improve longer-term clinical outcomes while, in terms of thrombolysis in myocardial infarction (TIMI) flow grade and myocardial blush grade (MBG), another study [ 7 ] demonstrated that thrombus aspiration with distal protection was superior when compared with aspiration alone. Although these studies [ 5 – 7 ] related to STEMI, the combination of these evidences clearly indicated that even after aspiration the risk of a significant amount of residual embolic material remaining meant using the best available protection procedures to prevent such embolic complications. Attempts were made to check for any previous reports addressing the efficacy of using an aspiration procedure in patients with stable coronary artery disease but none were found.…”

Section: Discussionmentioning

confidence: 99%

Synergistic ELCA-aspiration-DES thrombus removal strategy—embolus impact in high-risk plaque

Imai

Yamashita²,

Topaz³

2017

Medicine

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Rationale:Thin-cap fibroatheroma (TCFA) and red thrombus are suggested as a high-risk of embolic complications during percutaneous coronary intervention (PCI). Intracoronary aspiration procedures occasionally result in either an insufficient thrombus removal or provide no significant effects on TCFA.Patient concerns:A 76-year-old male underwent coronary angiography for chest pain.Diagnoses:Coronary angiography revealed a tight stenosis at the right coronary artery which resulted in treatment by PCI. Optical frequency domain imaging (OFDI) delineated a red thrombus with TCFA.Interventions:To avoid embolic complications, excimer laser coronary angioplasty (ELCA) was applied with intracoronary aspiration before drug-eluting stent (DES) implantation.Outcomes:The red thrombus was vaporized by ELCA in an energy-intensity dependent manner and subsequently removed by intracoronary aspiration. The fibrous cap of TCFA was dissected with the material beneath the cap ablated by ELCA and extensively removed by intracoronary aspiration. DES implantation and postdilatation achieved an optimal result without flow compromise. This combined synergistic strategy of ELCA-aspiration-DES yielded a successful outcome.Lessons:A synergistic embolus removal strategy combining ELCA, aspiration and DES implantation is a promising option for the treatment of high-risk plaque with potential embolic complications.

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Section: Discussionmentioning

confidence: 99%

Synergistic ELCA-aspiration-DES thrombus removal strategy—embolus impact in high-risk plaque

Imai

Yamashita²,

Topaz³

2017

Medicine

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“…For these patients, preventive modalities should be initiated before pPCI. Although the efficacies of embolic protection and mechanical thrombectomy devices [29,30] are vague, other preventive measures aimed at improving myocardial reperfusion at the microvascular level may be initiated prospectively and prove beneficial. Administration of a glycoprotein IIB/IIIA inhibitor, an intracoronary thrombolytic agent, or a high-dose adenosine infusion before pPCI was shown to be beneficial in some studies [31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Serum NT-proBNP on admission can predict ST-segment resolution in patients with acute myocardial infarction after primary percutaneous coronary intervention

Peng

Xia

et al. 2015

Herz

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Role of Sam68 as an adaptor protein in signal transduction

Najib

Martín-Romero

González-Yanes

et al. 2005

CMLS, Cell. Mol. Life Sci.

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Sam68, the substrate of Src in mitosis, belongs to the family of RNA binding proteins. Sam68 contains consensus sequences to interact with other proteins via specific domains. Thus, Sam68 has various proline-rich sequences to interact with SH3 domain-containing proteins. Moreover, Sam68 also has a C-terminal domain rich in tyrosine residues that is a substrate for tyrosine kinases. Tyrosine phosphorylation of Sam68 promotes its interaction with SH2 containing proteins. The association of Sam68 with SH3 domain-containing proteins, and its tyrosine phosphorylation may negatively regulate its RNA binding activity. The presence of these consensus sequences to interact with different domains allows this protein to participate in signal transduction pathways triggered by tyrosine kinases. Thus, Sam68 participates in the signaling of T cell receptors, leptin and insulin receptors. In these systems Sam68 is tyrosine phosphorylated and recruited to specific signaling complexes. The participation of Sam68 in signaling suggests that it may function as an adaptor molecule, working as a dock to recruit other signaling molecules. Finally, the connection between this role of Sam68 in protein-protein interaction with RNA binding activity may connect signal transduction of tyrosine kinases with the regulation of RNA metabolism.

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Comparison of the Reperfusion Efficacy of Thrombus Aspiration With and Without Distal Protection During Primary Percutaneous Coronary Intervention in Patients With Acute ST-Segment Elevation Myocardial Infarction

Cited by 6 publications

References 21 publications

Synergistic ELCA-aspiration-DES thrombus removal strategy—embolus impact in high-risk plaque

Synergistic ELCA-aspiration-DES thrombus removal strategy—embolus impact in high-risk plaque

Serum NT-proBNP on admission can predict ST-segment resolution in patients with acute myocardial infarction after primary percutaneous coronary intervention

Role of Sam68 as an adaptor protein in signal transduction

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