Rheolytic thrombectomy in patients with acute coronary syndrome and large thrombus burden: initial and mid-term results from a single centre experience.
BACKGROUND
The presence of a large intracoronary thrombus burden is a major complicating factor during percutaneous coronary intervention (PCI) in patients with an acute coronary syndrome (ACS). The use of rheolytic thrombectomy (RT) has been proposed to prevent thrombus-related complications, with conflicting results. The purpose of this study was to identify the feasibility and safety of this approach.


METHODS
We conducted a single-centre, retrospective, observational case-control study, comparing the outcomes of PCI in 26 consecutive patients with ACS and a large thrombus burden who underwent RT to those of a control group of 26 patients, matched with regard to artery location and initial TIMI flow grade.


RESULTS
Despite the higher prevalence of acute ST-elevation myocardial infarction and the larger thrombus burden in the RT group, there was less incidence of distal embolisation/no-reflow and less use of vasoactive intracoronary agents. The final TIMI flow was identical in both groups. There was no difference between the two groups in the in-hospital and mid-term incidence of major adverse coronary events.


CONCLUSIONS
In this study, the use of RT in patients with a large thrombus burden during acute PCI was both feasible and safe and reduced the incidence of initial no-reflow phenomenon.
Dardas
Petros
P
Department of Cardiology and Cardiothoracic Surgery, St. Luke's Hospital, Thessaloniki, Greece. pdardas@otenet.gr
Mezilis
Nikos
N
Ninios
Vlasis
V
Efthimiadis
Georgios K
GK
Tsikaderis
Dimitrios
D
Pagourelias
Efstathios
E
Pliakos
Christodoulos
C
D054058:Acute Coronary Syndrome / Q000601:surgery*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016022:Case-Control Studies; D003328:Coronary Thrombosis / Q000150:complications*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017131:Thrombectomy; D016896:Treatment Outcome