Mon faux-ami l'angiographie coronaire

Duband, Benjamin; Motreff, Pascal

doi:10.1016/j.ancard.2021.10.014

Cited by 2 publications

(2 citation statements)

References 15 publications

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“… 4 , 8 , 17 MVO may be caused by residual particles of the primary thrombus (microthrombi), tissue swelling or collapsed vessels in the microcirculation of the myocardium. 1 , 9 , 16 , 21 , 23 These poorly perfused or even non-perfused regions of the tissue are often not detected in the catheter laboratory due to the limited resolution of fluoroscopic angiography 5 and have substantial negative prognostic impact. 4 , 6 , 17 The gold standard for MVO diagnosis is non-perfusion within regions of Late-Gadolinium-Enhanced Cardiac Magnetic Resonance Imaging (LGE-CMRI).…”

Section: Introductionmentioning

confidence: 99%

Enhanced Drug Delivery for Cardiac Microvascular Obstruction with an Occlusion-Infusion-Catheter

Rösch

Eggenberger²,

Kuster³

et al. 2023

Ann Biomed Eng

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Microvascular Obstruction (MVO) is a common consequence of acute myocardial infarction. MVO is underdiagnosed and treatment is often nonspecific and ineffective. A multi-scale in-vitro benchtop model was established to investigate drug perfusion in MVO affected microcirculation. The central element of the benchtop model was a fluidic microchip containing channels with diameters between $$555$$ 555 and 50 μm representing $$2\%$$ 2 % of the microvascular tree fed by the left anterior descending artery (LAD). The outlets of the chip could be closed to mimic MVO. Two methods for intracoronary infusion of pharmacologic agents (simulated by dye) to regions with MVO were investigated using an occlusion-infusion catheter. The first case was a simple, bolus-like infusion into the LAD, whereas the second case consisted of infusion with concomitant proximal occlusion of the LAD phantom with a balloon. Results show that local dye concentration maxima in the chip with MVO were 2.2–3.2 times higher for the case with proximal balloon occlusion than for the conventional infusion method. The cumulated dose could be raised by a factor 4.6–5.2. These results suggest that drug infusion by catheter is more effective if the blood supply to the treated vascular bed is temporarily blocked by a balloon catheter.

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Section: Introductionmentioning

confidence: 99%

Enhanced Drug Delivery for Cardiac Microvascular Obstruction with an Occlusion-Infusion-Catheter

Rösch

Eggenberger²,

Kuster³

et al. 2023

Ann Biomed Eng

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show abstract

“…However, MVO cannot be detected during acute STEMI treatment due to the limited resolution of fluoroscopic angiography. 10 Today's gold standard for MVO diagnosis is based on detecting nonperfused regions using late-gadolinium-enhanced cardiac magnetic resonance imaging (MRI). 11 MRI, however, is impractical or even impossible in acute diagnosis and treatment of STEMI patients.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of catheter‐based drug delivery in a hybrid in vitro model of cardiac microvascular obstruction with porcine microthrombi

Rösch,

Stolte,

Weisskopf

et al. 2023

Bioengineering & Transla Med

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Microvascular obstruction (MVO) often occurs in ST‐elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI). Diagnosis and treatment of MVO lack appropriate and established procedures. This study focused on two major points by using an in vitro multiscale flow model, which comprised an aortic root model with physiological blood flow and a microfluidic model of the microcirculation with vessel diameters down to 50 μm. First, the influence of porcine microthrombi (MT), injected into the fluidic microchip, on perfusion was investigated. We found that only of all injected MT were fully occlusive. Second, it could also be shown that the maximal concentration of a dye (representing therapeutic agent) during intracoronary infusion could be increased on average by , when proximally occluding the coronary artery by a balloon during drug infusion. The obtained results and insights enhance the understanding of perfusion in MVO‐affected microcirculation and could lead to improved treatment methods for MVO patients.

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Mon faux-ami l'angiographie coronaire

Cited by 2 publications

References 15 publications

Enhanced Drug Delivery for Cardiac Microvascular Obstruction with an Occlusion-Infusion-Catheter

Enhanced Drug Delivery for Cardiac Microvascular Obstruction with an Occlusion-Infusion-Catheter

Efficacy of catheter‐based drug delivery in a hybrid in vitro model of cardiac microvascular obstruction with porcine microthrombi

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