1. Intracoronary glycoprotein IIb/IIIa inhibitor infusion via a perfusion coronary catheter to decrease thrombus burden: results from the ClearWay™ Multicenter Registry.
- Author
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Maluenda G, Sizemore BC, Revtyak G, Cavros N, McElroy BB, Arora DS, Deibele A, Makam S, Ben-Dor I, Torguson R, and Waksman R
- Subjects
- Aged, Coronary Angiography, Coronary Artery Disease blood, Coronary Artery Disease diagnosis, Coronary Artery Disease physiopathology, Coronary Circulation drug effects, Coronary Thrombosis blood, Coronary Thrombosis diagnosis, Coronary Thrombosis physiopathology, Coronary Vessels diagnostic imaging, Coronary Vessels physiopathology, Equipment Design, Female, Health Care Surveys, Humans, Infusions, Intra-Arterial, Male, Middle Aged, Platelet Glycoprotein GPIIb-IIIa Complex metabolism, Registries, Surveys and Questionnaires, Time Factors, Treatment Outcome, United States, Cardiac Catheterization instrumentation, Cardiac Catheters, Coronary Artery Disease therapy, Coronary Thrombosis therapy, Coronary Vessels drug effects, Percutaneous Coronary Intervention adverse effects, Platelet Aggregation Inhibitors administration & dosage, Platelet Glycoprotein GPIIb-IIIa Complex antagonists & inhibitors
- Abstract
Objectives: 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., Conclusion: 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., (Copyright © 2013. Published by Elsevier Inc.)
- Published
- 2013
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