782-6 Clinical and Angiographic Followup to a Prospective Study of Transluminal Extraction Atherectomy in High Risk Patients with Acute Myocardial Infarction
Journal of The American College of Cardiology(1995)
Abstract
Acute myocardial infarction (AMI) patients with an infarct related artery (IRA) containing thrombus are a high risk group for percutaneous transluminal coronary angioplasty. TEC may be a useful device for treatment of these patients due to its ability to aspirate thrombus. TEC was prospectively evaluated in 63 patients (age 61 ± 12 years) including 23 (36.5%) ineligible for thrombolysis, 24 (38%) with lytic failure, and 16 (25.5%) with post infarct angina and a thrombotic coronary occlusion. Immediate, one week, and six month angiographic and clinical followup were obtained. The IRA was a SVG in 18 (29%) and a native coronary artery (NAT) in 45 (71%). Acute procedural success with a residual stenosis l 50% and TIMI 2 or 3 grade flow was acheived in 94% of patients. There were no major procedural complications. Other events during the hospitalization included death in 3 (4.8%), CABG in 2 (3%) and blood transfusion in 12 (19%). Elective predischarge angiography revealed an IRA stenosis l 50% in 34/38 (89%). Patients were followed for 6 months with clinical followup in 100% and angiographic in 38/63. Death CABG Patency at F/U IRA RePTCA NAT 3/45 (6.7%) 1145 (2.2%) 29/31 (94%) 15/45 (33%) SVG 4/18 (22.2%) 2/18 (11.1%) 4/7 (57%) 4/18 (22%) TOTAL 7/63 (11.1%) 3/63 (4.8%) 34/38 (90%) 19/63 (30%) Angiographic restenosis occurred in 27/38 (71%) although most patients returned for followup cath secondary to symptom recurrence. Clinical restenosis occurred in 22 (42%). Conclusions High risk AMI patients can be successfully treated with TEC with a high technical success rate and a low incidence of complications. IRA patency at 1 week and 6 months was excellent; however, angiographic restenosis remains a problem. Extraction of thrombus in AMI may help maintain vessel patency but does not appear to prevent restenosis.
MoreTranslated text
Key words
prospective study,acute myocardial infarction
AI Read Science
Must-Reading Tree
Example
Generate MRT to find the research sequence of this paper
Chat Paper
Summary is being generated by the instructions you defined