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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
Rivista di Medicina Interna e Farmacologia
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2016 November;175(11):491-5
Manual aspiration catheters with different in vivo efficacy in acute myocardial infarction: a study of two cases
Andrzej TOMASIK, Kinga TYRAŁA, Monika PANICZEK, Ewa NOWALANY-KOZIELSKA
Second Department of Cardiology, Medical University of Silesia, Zabrze, Poland
BACKGROUND: Meta-analyses of randomized trials comparing adjunctive manual thrombectomy with primary percutaneous angioplasty alone in patients with acute myocardial infarction have raised doubts regarding the efficacy and safety of thrombectomy. Although in vivo comparisons have claimed similar efficacy of different aspiration catheters, in vitro tests have shown important differences in their performance.
METHODS: We report on two cases, in each of which use of two different aspiration catheters was required to successfully retrieve a clot from the coronary artery. Catheterization was performed using a Philips Integris Allura cath lab. In both cases, 6F diagnostic and interventional tools were used. Archived DICOM images were post-processed using a Philips Interventional Workspot.
RESULTS: Right coronary artery was infarct-related vessel with TIMI III or IV grade thrombus respectively. Attempts to retrieve the thrombi with a Pollux aspiration catheter were unsuccessful. We succeeded with a guiding catheter in the first case and a 3Flow aspiration catheter in the second case. After stenting the culprit artery, we achieved final TIMI III flow and grade III myocardial blush in both cases.
CONCLUSIONS: Some aspiration catheters might have limited efficacy in thrombus removal; in these cases, an alternative approach with a different aspiration catheter is warranted.