title: Rheolytic thrombectomy in patients with acute coronary syndrome and large thrombus burden: initial and mid-term results from a single centre experience.
abstract: 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.
authors.affiliation: Department of Cardiology and Cardiothoracic Surgery, St. Luke's Hospital, Thessaloniki, Greece. pdardas@otenet.gr
authors.forename: Petros
authors.initials: P
authors.lastname: Dardas
authors.forename: Nikos
authors.initials: N
authors.lastname: Mezilis
authors.forename: Vlasis
authors.initials: V
authors.lastname: Ninios
authors.forename: Georgios K
authors.initials: GK
authors.lastname: Efthimiadis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tsikaderis
authors.forename: Efstathios
authors.initials: E
authors.lastname: Pagourelias
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Pliakos
mesh_terms: 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