Does Residual Thrombus After Aspiration Thrombectomy Affect the Outcome of Primary PCI in Patients With ST-Segment Elevation Myocardial Infarction?

Higuma, Takumi; Soeda, Tsunenari; Yamada, Masahiro; Yokota, Takashi; Yokoyama, Hiroaki; Izumiyama, Kei; Nishizaki, Fumie; Minami, Yoshiyasu; Liu, Xing; Yamamoto, Etsuhide; Lee, Hang; Okumura, Ken; Jang, Ik‐Kyung

doi:10.1016/j.jcin.2016.06.050

Cited by 53 publications

(41 citation statements)

References 26 publications

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“…In the ESC guideline (2017), routine thrombus aspiration is not recommended 19) . As it was reported that STEMI patients with a greater residual thrombus burden after aspiration thrombectomy had worse microvascular function and larger myocardial damage than patients with a smaller residual thrombus burden 20) , thrombectomy should be chosen carefully. In the present case, we repeated thrombus aspiration, but could not remove the blood clot effectively.…”

Section: Discussionmentioning

confidence: 99%

A Case of No-reflow Phenomenon Improved by Intracoronary Nitroprusside Injection with Lumine™ Infusion Catheter

Sugawara

Ohwada

Watanabe

et al. 2020

Journal of Coronary Artery Disease

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Section: Discussionmentioning

confidence: 99%

A Case of No-reflow Phenomenon Improved by Intracoronary Nitroprusside Injection with Lumine™ Infusion Catheter

Sugawara

Ohwada

Watanabe

et al. 2020

Journal of Coronary Artery Disease

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“…Studies have shown that intracoronary thrombi can lead to micro- and macro-vasculature embolization and is associated with poor outcomes in patients who underwent PPCI of culprit lesion. 6 - 8 However, management of thrombotic burden is still challenging during PPCI for STEMI. Early risk stratification to detect patients at high risk of high thrombus burden is very important for the individualized prevention and treatment of this condition.…”

Section: Discussionmentioning

confidence: 99%

Association of Monocyte Count on Admission with the Angiographic Thrombus Burden in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Wang¹,

Liu²,

Ren³

et al. 2018

Arquivos Brasileiros De Cardiologia

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BackgroundThe intracoronary high-thrombus burden during the primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction (STEMI) can lead to poor outcomes. Monocytes have been described to play an important role in thrombotic disorders.ObjectivesThis study aimed to investigate the relationship between admission monocyte count and angiographic intracoronary thrombus burden in patients receiving primary percutaneous coronary intervention (PPCI).MethodsA total of 273 patients with acute STEMI who underwent PPCI were enrolled. The patients were divided into two groups according to the thrombolysis in myocardial infarction (TIMI) thrombus grade: low-thrombus burden group with a grade of 0-2 and high-thrombus burden group with a grade of 3-4. The monocyte count and other laboratory parameters were measured on admission before PPCI. P-value < 0.05 was considered significant.ResultsThere were 95 patients (34.8%) in the high-thrombus burden group, and 178 patients (65.2%) in the low-thrombus burden group. Patients with high-thrombus burden had significantly higher admission monocyte count (0.61 ± 0.29×109/L vs. 0.53 ± 0.24×109/L, p = 0.021). In multivariate analysis, monocyte count was the independent predictor of angiographic high-thrombus burden (odds ratio 3.107, 95% confidence interval [CI] 1.199-7.052, p = 0.020). For the prediction of angiographic high-thrombus burden, admission monocyte count at a cut-off value of 0.48×109/L yielded 0.59 ROC-AUC (71.9% sensitivity, 46.9% specificity).ConclusionsMonocyte count on admission was an independent clinical predictor of high-thrombus burden in patients with STEMI undergoing PPCI. Our findings suggest that admission monocyte count may be available for early risk stratification of high-thrombus burden in acute STEMI patients and might allow the optimization of antithrombotic therapy to improve the outcomes of PPCI.

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“…Thrombus aspiration is an adjunctive non-pharmacological strategy during primary PCI designed to improve epicardial and myocardial reperfusion. However, recent studies failed to show the clinical benefit of aspiration thrombectomy in STEMI patients due to insufficient removal of thrombus at the culprit lesion [19][20][21].…”

Section: Optimal Lesion Preparation For Dcb Applicationmentioning

confidence: 99%

Provisional drug-coated balloon treatment guided by physiology on de novo coronary lesion

et al. 2021

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Although drug-eluting stents (DES) have become the mainstay of percutaneous coronary intervention, late and very late stent thrombosis remains a concern. Drug-coated balloons (DCB) have the advantage of preserving the anti-restenotic benefits of DES while minimizing potential long-term safety concerns. Currently the two methods to ensure successful DCB treatment of a stenotic lesion are angiography or physiology-guided DCB application. This review will evaluate these two methods based on previous evidence and make suggestions on how to perform DCB treatment more efficiently and safely.

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Does Residual Thrombus After Aspiration Thrombectomy Affect the Outcome of Primary PCI in Patients With ST-Segment Elevation Myocardial Infarction?

Abstract: STEMI patients with greater residual thrombus burden after aspiration thrombectomy had worse microvascular dysfunction and greater myocardial damage compared with those with smaller residual thrombus burden.

Cited by 53 publications

References 26 publications

A Case of No-reflow Phenomenon Improved by Intracoronary Nitroprusside Injection with Lumine™ Infusion Catheter

A Case of No-reflow Phenomenon Improved by Intracoronary Nitroprusside Injection with Lumine™ Infusion Catheter

Association of Monocyte Count on Admission with the Angiographic Thrombus Burden in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Provisional drug-coated balloon treatment guided by physiology on de novo coronary lesion

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