Mechanical Prevention of Distal Embolization During Primary Angioplasty

Limbruno, Ugo; Micheli, Andrea De; Carlo, Marco De; Amoroso, Giovanni; Rossini, Roberta; Palagi, Caterina; Bello, Vitantonio Di; Petronio, Anna Sonia; Fontanini, Gabriella; Mariani, Mario

doi:10.1161/01.cir.0000079223.47421.78

Cited by 134 publications

(102 citation statements)

References 42 publications

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“…Although the use of GuardWire during primary PCI in AMI does not improve microvascular flow or function, reduce infarct size, or enhance long-term eventfree survival, 82,83 most studies confirm that distal protection devices may prevent many unfavourable events by limiting embolization and improving outcomes. Distal embolization may be successfully minimized by using the AngioGuard Emboli Capture Guidewire (Cordis).…”

Section: Distal Embolization Prevention and Intra-aortic Balloon Counmentioning

confidence: 99%

Coronary microvascular reperfusion injury and no-reflow in acute myocardial infarction

Kang

Yang

2007

CIM

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Purpose: To review (1) the mechanisms of coronary microvascular reperfusion injury, particularly in the relationships between microvascular endothelium dysfunction, microstructure damage, microemboli and no-reflow phenomena; (2) the no-reflow presentation and management at ischemia-reperfusion to suggest future direction for noreflow therapy in acute myocardial infarction. Sources: Original articles and reviews published between 1997 and 2007 and focusing on the no-reflow phenomenon in MEDLINE and PubMed. The search terms used were "no-reflow", "microvascular injury", "acute myocardial infarction" and "reperfusion injury". All papers identified were English-language, full text papers. In addition, the reference lists of identified relevant articles were also searched. Conclusions:The no-reflow phenomenon is characterised by damage to microvascular function and microstructure at ischaemia-reperfusion. Microemboli contribute to noreflow. Clinical myocardial contrast echocardiography (MCE), scintigraphic and magnetic resonance imaging (MRI) have shown evidence of microvascular damage, eg, perfusion defects are closely related to lack of contractile recovery and irreversible myocyte damage. Clinical agents and devices targeting microvascular injury (especially protection of endothelium and reduction of microemboli) after acute myocardial infarction may be key points to improve no-reflow.

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Section: Distal Embolization Prevention and Intra-aortic Balloon Counmentioning

confidence: 99%

Coronary microvascular reperfusion injury and no-reflow in acute myocardial infarction

Kang

Yang

2007

CIM

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“…Moreover, another report demonstrated that distal protection during PCI effectively retrieved the embolic debris and preserved the index of microcirculatory resistance in patients with an acute anterior STEMI [14]. Embolic protection devices are designed to be able to retrieve atherothrombotic debris and prevent its distal embolisation, but their effect on clinical outcomes has not been established, except for saphenous vein bypass grafts [6,7,[15][16][17].…”

Section: Discussionmentioning

confidence: 99%

In vitro assessment of six aspiration catheters using a distal protection filter

Fujimura

Okamura

Ando³

et al. 2016

Cardiol J.

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Results: Among the 6 catheters evaluated, the use of the Export Advance catheter (Medtronic) resulted in significantly shorter lengths of the suspended embolus matter compared to the use of the TVAC II (Nipro), Thrombuster III SL (Kaneka), and Rebirth Pro (Goodman) catheters (p < 0.01). The residual embolus matter in all cases had drained distally to the distal protection filter when the filter was retrieved. Conclusions:The use of the Export Advance catheter showed better performance using a distal protection filter in this in vitro experiment, and its use might be more effective in preventing distal embolisms in combination with a distal protection filter. (Cardiol J 2016; 23, 6: 667-672)

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“…Distal embolization of thrombus during balloon inflation or stent deployment carries an increased risk of poor clinical outcomes; [8][9][10][11][12] in a recent study, it was associated with an 8-fold increase in 5-year mortality.…”

Section: Discussionmentioning

confidence: 99%

Aspiration Thrombectomy of a Massive Thrombotic Embolus in Acute Myocardial Infarction Caused by Coronary Embolism

Sakai

Inoue

Nobuyoshi³

2007

Int. Heart J.

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SUMMARYCoronary embolism is one of the less common causes of acute myocardial infarction (AMI). We describe a 72-year-old man with atrial fibrillation having an AMI, in whom a massive intracoronary thrombus of the right coronary artery was successfully removed by aspiration via a thrombectomy catheter, achieving successful reperfusion with a complete resolution of ST-segment elevation. The appearance of the aspirated material suggested coronary embolism was the cause of the AMI. It is concluded aspiration thrombectomy is a feasible and safe approach for treating coronary embolism. (Int Heart J 2007; 48: 387-392) Key words: Acute myocardial infarction, Coronary embolism, Aspiration thrombectomy, Atrial fibrillation ALTHOUGH disruption of atherosclerotic plaques and intracoronary thrombus formation is widely accepted as the main pathophysiological cause for the development of acute myocardial infarction (AMI), 1) coronary embolism is one of the less common causes of AMI. In this report, we describe a patient with AMI most likely caused by coronary embolism complicating atrial fibrillation and evidence of a massive thrombus in the infarct-related artery in whom aspiration via a thrombectomy catheter resulted in effective removal of a massive thrombus and successful reperfusion was achieved. CASE REPORTA 72-year-old man was admitted to our emergency room with constant severe chest pain lasting about 21 minutes. His diabetes was controlled with diet therapy. He had a history of coronary stent implantation of the left anterior descending artery for unstable angina 2 years before this admission. Past medical From the

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Mechanical Prevention of Distal Embolization During Primary Angioplasty

Abstract: Background-Effective myocardial reperfusion after primary percutaneous coronary intervention (PCI) may be limited by distal embolization. We tested the safety, feasibility, and efficacy of the FilterWire-Ex (FW), a distal embolic protection device, as an adjunct to primary PCI.

Cited by 134 publications

References 42 publications

Coronary microvascular reperfusion injury and no-reflow in acute myocardial infarction

Coronary microvascular reperfusion injury and no-reflow in acute myocardial infarction

In vitro assessment of six aspiration catheters using a distal protection filter

Aspiration Thrombectomy of a Massive Thrombotic Embolus in Acute Myocardial Infarction Caused by Coronary Embolism

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