title: Thrombus-aspiration through 5 Fr guiding catheter with transradial approach in acute coronary syndromes: feasibility of a mini-invasive strategy.
abstract: OBJECTIVE
  The purpose of this study was to assess the feasibility and safety of thrombus-aspiration through a 5 Fr guiding catheter with transradial approach in acute coronary syndromes.
  
  
  BACKGROUND
  The use of thrombus-aspirating devices improves myocardial reperfusion but requires at least a 6 Fr guiding catheter. Transradial coronary interventions using a 5 Fr guiding catheter are attractive to reduce bleeding complications.
  
  
  METHODS
  We retrospectively selected patients presenting acute coronary syndromes with angiographically visible thrombus who underwent thrombus-aspiration through radial access using a 4 Fr multipurpose catheter in a 5 Fr guiding catheter. We described clinical and angiographic characteristics of the cohort, and the procedure's technique, success and complications.
  
  
  RESULTS
  Among the 34 included patients, 29 presented ST-segment elevation myocardial infarction. Complete resolution of the ST-segment elevation was effective in 93% of these patients. TIMI flow grade after thrombus-aspiration was significantly improved compared to baseline TIMI flow grade or after passage of the guidewire (P < 0.001 for both). There was no dissection or perforation but we noted distal embolization in 5 cases probably explained by the high grade of intracoronary thrombus in our cohort.
  
  
  CONCLUSIONS
  Thrombus-aspiration through a 5 Fr guiding catheter with transradial approach seems to be safe and effective in selected patients with acute coronary syndrome. This mini-invasive approach brought the advantages of the transradial access in 5 Fr but also its limitations.
authors.affiliation: CHU de Caen, Department of Cardiology, Caen F-14000, France. v.roule@hotmail.fr
authors.forename: Vincent
authors.initials: V
authors.lastname: Roule
authors.forename: Ziad
authors.initials: Z
authors.lastname: Dahdouh
authors.forename: Julien
authors.initials: J
authors.lastname: Wain-Hobson
authors.forename: Mathieu
authors.initials: M
authors.lastname: Bignon
authors.forename: Guillaume
authors.initials: G
authors.lastname: Malcor
authors.forename: Thérèse
authors.initials: T
authors.lastname: Lognoné
authors.forename: Paul
authors.initials: P
authors.lastname: Milliez
authors.forename: Gilles
authors.initials: G
authors.lastname: Grollier
authors.forename: Rémi
authors.initials: R
authors.lastname: Sabatier
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications*; D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation*; D015331:Cohort Studies; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000209:etiology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D012189:Retrospective Studies; D013396:Suction / Q000009:adverse effects / Q000379:methods*