title: Successful thrombus extraction with the Rescue thrombus management system during acute percutaneous coronary intervention improves flow but does not necessarily restore optimal myocardial tissue perfusion.
abstract: We determined the effectiveness of the Rescue device in restoring flow and achieving optimal tissue perfusion during percutaneous coronary intervention (PCI) in thrombus-laden coronary arteries.
  
  
  METHODS
  A total of 30 patients with an acute coronary syndrome underwent PCI using the Rescue device.
  
  
  RESULTS
  The mean age was 65.5 +/- 9.8 years. Although the Rescue device could not be passed across the lesion in 6 (20%) cases, debris was aspirated in 26 (87%). The uncorrected TIMI frame count improved following the use of the Rescue device and improved further at the completion of PCI (92.2 +/- 23.9 pre-PCI vs. 38.7 +/- 31.3 post-Rescue vs. 21.96 +/- 24 post-PCI, P < 0.0001). The thrombus score improved from 4 +/- 0 to 2.2 +/- 1.29 to 0.86 +/- 1.4 (P < 0.0001). TIMI flow grade (TFG) 3 was restored in 60% of cases following the Rescue device and in 87% after PCI. Myocardial blush grade 3 occurred in only 13% of patients following the Rescue device and 37% of patients after PCI.
  
  
  CONCLUSIONS
  These data suggest that the Rescue device can aspirate considerable amounts of debris in the majority of patients and significantly improves the angiographic epicardial coronary blood flow. How effective such a device is in improving tissue perfusion and, thereby, clinical outcomes for patients remains to be seen.
authors.affiliation: Department of Cardiology, the James Cook University Hospital, Middlesbrough, United Kingdom.
authors.forename: Kunadian
authors.initials: K
authors.lastname: Vijayalakshmi
authors.forename: Babu
authors.initials: B
authors.lastname: Kunadian
authors.forename: Robert A
authors.initials: RA
authors.lastname: Wright
authors.forename: Andrew G C
authors.initials: AG
authors.lastname: Sutton
authors.forename: James A
authors.initials: JA
authors.lastname: Hall
authors.forename: Mark A
authors.initials: MA
authors.lastname: de Belder
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017225:Atherectomy, Coronary / Q000379:methods; D017023:Coronary Angiography; D003326:Coronary Circulation; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D004617:Embolism / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency