Thrombus Aspiration with Export Catheter in ST Elevation Myocardial Infarction

Abstract

Our study demonstrates that routine use of EXPORT catheter in patients with STEMI and coronary thrombosis is feasible, safe, and associated with significant improvements in flow-related angiographic parameters. The relative simplicity of this approach makes it an attractive option in this challenging situation.

Should the practicing interventionalist use manual aspiration systematically in all patients or only in selected patients with an angiographically obvious thrombotic burden?

“…Ciszewski et al [6] showed that in their study of 137 patients with angiographic evidence of thrombus load undergoing manual thrombectomy against standard PCI, in-hospital mortality did not differ significantly, 3 vs 4% (P = 1.0) for thrombectomy vs standard PCI, respectively. A similar patient mortality rate of 4.5% from cardiac death following selective manual aspiration was found by Margheri et al [8] in 129 consecutive patients treated with the Export catheter device.…”

Use of the TIMI frame count in the assessment of coronary artery blood flow and microvascular function over the past 15 years

“…Likewise the following devices have all been associated with faster (lower) CTFCs: the EXPORT thrombus extraction catheter (EXPORT, Medtronic Inc., Minnesota, MN) (P = 0.0001) [71]; the PercuSurge GuardWire TM (distal protection device, Medtronic AVE) (P \ 0.01) [72,73] [76]; and finally manual thrombus aspiration using the Pronto TM extraction catheter (Vascular solutions, Minneapolis, Minnesota) before primary PCI (21.5 ± 12 vs. 17.3 ± 6) using the extraction catheter (P \ 0.01) [77].…”

Elevation of matrix metalloproteinases and interleukin‐6 in the culprit coronary artery of myocardial infarction

“…A device recently developed for percutaneous coronary intervention (PCI) is capable of aspirating blood, thrombus and plaque from the site of coronary occlusion. Aspiration therapy helps to prevent the no‐reflow phenomenon [11–14], a cause of embolization of plaque material into the microcirculation. Thus far, no one has produced an animal model to adequately approximate the rupture of atherosclerotic plaque as it occurs in humans [15].…”