Rheolytic thrombectomy in patients with ST-elevation myocardial infarction and large thrombus burden: the Thoraxcenter experience

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dc.contributor.authorSianos, G.en
dc.contributor.authorPapafaklis, M. I.en
dc.contributor.authorVaina, S.en
dc.contributor.authorDaemen, J.en
dc.contributor.authorvan Mieghem, C. A.en
dc.contributor.authorVan Domburg, R. T.en
dc.contributor.authorMichalis, L. K.en
dc.contributor.authorde Jaegere, P.en
dc.contributor.authorSerruys, P. W.en
dc.date.accessioned2015-11-24T18:53:28Z
dc.date.available2015-11-24T18:53:28Z
dc.identifier.issn1557-2501-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/18568
dc.rightsDefault Licence-
dc.subjectAgeden
dc.subjectCoronary Angiographyen
dc.subjectCoronary Thrombosis/*complications/mortality/physiopathology/*therapyen
dc.subjectDrug Delivery Systemsen
dc.subject*Electrocardiographyen
dc.subjectFemaleen
dc.subjectFollow-Up Studiesen
dc.subjectHumansen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectMyocardial Infarction/*complications/physiopathology/radiography/therapyen
dc.subjectRecurrenceen
dc.subjectRetrospective Studiesen
dc.subjectSeverity of Illness Indexen
dc.subjectStentsen
dc.subjectSurvival Analysisen
dc.subjectThrombectomy/*methodsen
dc.subjectTreatment Outcomeen
dc.titleRheolytic thrombectomy in patients with ST-elevation myocardial infarction and large thrombus burden: the Thoraxcenter experienceen
heal.abstractOBJECTIVES: To determine the impact of Rheolytic thrombectomy (RT) on the clinical and angiographic outcome of patients with ST-elevation myocardial infarction (STEMI) and large thrombus burden (LTB). METHODS: Two hundred sixty-six consecutive patients who presented from April 2002 until December 2004 with STEMI and LTB were retrospectively analyzed. LTB was defined as definite presence of thrombus with the greatest dimension greater > or = 2 vessel diameters by visual assessment. RT, as well as the interventional procedure and the peri-procedural pharmacological therapy, was at the discretion of the operator. All patients were followed for major adverse cardiac events (MACE) defined as death, non-fatal myocardial infarction (MI) and infarct-related artery revascularization. Pre- and post-procedural thrombolysis in myocardial infarction (TIMI) flow and thrombus burden as well as myocardial blush, distal embolization and no reflow were also determined. RESULTS: Complete follow-up was available in all patients; mean duration was 17 +/- 8.7 months. RT was used in 75 patients (28.2%). Stents were implanted in 251 (94.4%) patients; drug-eluting stents in 210 (84.6%) patients (15.5% sirolimus-eluting stents and 69.1% paclitaxel-eluting stents). The 2-year cumulative survival and MACE-free survival were higher in the RT compared to the non-RT group (92% vs. 82.7%, p = 0.051 and 87.7% vs. 69.9%, p = 0.004, respectively). Post-procedure indices (TIMI 3 flow, absence of thrombus and myocardial blush grade 3) of angiographic outcome were significantly better in the RT group. RT was an independent predictor of MACE (HR: 0.45, 95% CI: 0.22-0.93, p = 0.03). CONCLUSIONS: RT significantly improves the clinical and angiographic outcome of patients with STEMI and large thrombus burden.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/16883024-
heal.journalNameJ Invasive Cardiolen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2006-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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