title: Intracoronary glycoprotein IIb/IIIa inhibitor infusion via a perfusion coronary catheter to decrease thrombus burden: results from the ClearWay™ Multicenter Registry.
abstract: OBJECTIVE
  This multicenter registry aimed to assess the ClearWay™ (CW) perfusion catheter in reduction of thrombus burden and improvement of the coronary flow during percutaneous coronary intervention (PCI).
  
  
  BACKGROUND
  The presence or development of thrombus during PCI is associated with poor prognosis.
  
  
  METHODS
  The utility of the CW perfusion catheter was assessed in patients who presented with intracoronary thrombus and were subjected to PCI. Data were collected by online survey from 15 US sites. Angiographic assessment of the coronary thrombus burden and the coronary flow after intracoronary infusion of glycoprotein (GP) IIb/IIIa inhibitors via the CW catheter was evaluated at baseline, immediately after infusion, and at the end of the procedure. The cohort included 102 patients; 71.6% presented with ST-elevation myocardial infarction (MI), 21.6% with non-ST-elevation MI, 5.9% with stable angina pectoris, and 2.9% with silent ischemia. The mean cohort age was 59.9±14.5years and comprised mostly of men (72.5%).
  
  
  RESULTS
  GP IIb/IIIa inhibitors were infused via the CW catheter on average 1.1±0.3 times, with a mean pressure of 4.2±2.7atm and a mean infusion time of 55±55s. Following the infusion, Thrombolysis In Myocardial Infarction (TIMI) flow improved by 1° in 71 patients (69.6%) and by 2° in 51 patients (50%), while visible thrombus was reduced by 52% (p<0.001). In the final angiogram, TIMI flow was restored in 90.2% and clearance of a visible thrombus was obtained in 91.8% of the lesions.
  
  
  CONCLUSIONS
  Intracoronary infusion of GP IIb/IIIa inhibitors via the perfusion CW catheter is associated with significant reduction in thrombus burden and with improvement of the coronary flow in patients presenting or developing thrombus burden during PCI.
authors: Washington Hospital Center, Washington, DC 20010, USA.
authors: Gabriel
authors: G
authors: Maluenda
authors: Byron C
authors: BC
authors: Sizemore
authors: George
authors: G
authors: Revtyak
authors: Nick
authors: N
authors: Cavros
authors: Bradley B
authors: BB
authors: McElroy
authors: Dilip S
authors: DS
authors: Arora
authors: Al
authors: A
authors: Deibele
authors: Satyaprakash
authors: S
authors: Makam
authors: Itsik
authors: I
authors: Ben-Dor
authors: Rebecca
authors: R
authors: Torguson
authors: Ron
authors: R
authors: Waksman
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation*; D062906:Cardiac Catheters; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D003326:Coronary Circulation / Q000187:drug effects; D003328:Coronary Thrombosis / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D004867:Equipment Design; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors* / Q000378:metabolism; D012042:Registries; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex
keywords: Glycoprotein inhibitor; Perfusion catheter; Thrombus burden