title: Safety and feasibility of X-sizer-facilitated rescue percutaneous coronary intervention: a preliminary experience.
abstract: Failed thrombolysis following ST-elevation myocardial infarction (STEMI) is associated with a poor prognosis. Rescue balloon angioplasty with or without stent implantation is an established treatment for failed thrombolysis. Recently, X-Sizer thrombectomy has been shown to be effective in removing intracoronary thrombi and improving coronary perfusion in patients with acute coronary syndrome. In this retrospective study, we sought to evaluate the safety and feasibility of X-Sizer-facilitated rescue percutaneous coronary intervention (PCI) for the treatment of STEMI after failed thrombolysis. Clinical data are from a retrospective review of 95 patients who underwent X-Sizer-facilitated primary PCI (n = 80) or rescue PCI (n = 15) during the period from November 2000 to February 2003. Baseline and procedural characteristics of the 2 groups were similar, except for a higher prevalence of hypercholesterolemia in the rescue PCI group. Angiographic success was achieved in 96% in the primary PCI group and 100% in the rescue PCI group. The 30-day mortality (7.5% vs. 13.3%), major acute coronary event (MACE; 7.5% vs. 13.3%), and MACE with angina (15% vs. 13.3%) rates were similar between the primary PCI and the rescue PCI groups. Similarly, the 6-month mortality (10% vs. 13.3%), MACE (16.3% vs. 13.3%) and MACE with angina (25% vs. 26.7%) rates were also comparable (p = NS for all comparison). In particular, there were no incidences of death, reinfarction or repeat revascularization between 30 days and 6 months in the rescue PCI group. In conclusion, X-Sizer-facilitated rescue PCI was safe and feasible. The outcomes of patients who underwent X-Sizer-facilitated rescue PCI were similar to those who underwent X-Sizer-facilitated primary PCI.
authors.affiliation: Cardiac Department, National University Hospital, Singapore. leerch@hotmail.com
authors.forename: Chi Hang
authors.initials: CH
authors.lastname: Lee
authors.forename: Huay Cheem
authors.initials: HC
authors.lastname: Tan
authors.forename: Swee Guan
authors.initials: SG
authors.lastname: Teo
authors.forename: Antono
authors.initials: A
authors.lastname: Sutandar
authors.forename: Yean Teng
authors.initials: YT
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D017023:Coronary Angiography; D004869:Equipment Safety; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome