The failing aspirations of aspiration thrombectomy in STEMI

2021 ◽  
Author(s):  
Huu Tam D. Truong ◽  
Kwan S. Lee
Keyword(s):  
Aspiration Thrombectomy

Optimum Therapies for ST-Elevation Myocardial Infarction Managed with Primary Percutaneous Coronary Intervention

2012 ◽  
Vol 7 (2) ◽  
pp. 81
Author(s):  
Bruce R Brodie ◽  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Great Majority ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Stent Deployment ◽  
Aspiration Thrombectomy ◽  
Percutaneous Coronary ◽  
St Elevation

This article reviews optimum therapies for the management of ST-elevation myocardial infarction (STEMI) with primary percutaneous coronary intervention (PCI). Optimum anti-thrombotic therapy includes aspirin, bivalirudin and the new anti-platelet agents prasugrel or ticagrelor. Stent thrombosis (ST) has been a major concern but can be reduced by achieving optimal stent deployment, use of prasugrel or ticagrelor, selective use of drug-eluting stents (DES) and use of new generation DES. Large thrombus burden is often associated poor outcomes. Patients with moderate to large thrombus should be managed with aspiration thrombectomy and patients with giant thrombus should be treated with glycoprotein IIb/IIIa inhibitors and may require rheolytic thrombectomy. The great majority of STEMI patients presenting at non-PCI hospitals can best be managed with transfer for primary PCI even with substantial delays. A small group of patients who present very early, who are at high clinical risk and have long delays to PCI, may best be treated with a pharmaco-invasive strategy.

Front-line thrombectomy for acute large-vessel occlusion with underlying severe intracranial stenosis: stent retriever versus contact aspiration

2020 ◽  
Vol 132 (4) ◽  
pp. 1202-1208 ◽  
Author(s):  
Dong-Hun Kang ◽  
Woong Yoon ◽  
Byung Hyun Baek ◽  
Seul Kee Kim ◽  
Yun Young Lee ◽  
...  
Keyword(s):  
Binary Logistic Regression ◽  
Stent Retriever ◽  
Large Vessel ◽  
Binary Logistic Regression Analysis ◽  
Large Vessel Occlusion ◽  
Front Line ◽  
Vessel Occlusion ◽  
Aspiration Thrombectomy ◽  
Atherosclerotic Stenosis ◽  
Antegrade Flow

OBJECTIVEThe optimal front-line thrombectomy choice for primary recanalization of a target artery remains unknown for patients with acute large-vessel occlusion (LVO) and an underlying intracranial atherosclerotic stenosis (ICAS). The authors aimed to compare procedural characteristics and outcomes between patients who received a stent-retriever thrombectomy (SRT) and patients who received a contact aspiration thrombectomy (CAT), as the front-line approach for treating LVO due to severe underlying ICAS.METHODSOne hundred thirty patients who presented with acute LVO and underlying severe ICAS at the occlusion site were included. Procedural characteristics and treatment outcomes were compared between patients treated with front-line SRT (n = 70) and those treated with front-line CAT (n = 60). The primary outcomes were the rate of switching to an alternative thrombectomy technique, time from groin puncture to initial reperfusion, and duration of the procedure. Initial reperfusion was defined as revealing the underlying culprit stenosis with an antegrade flow after thrombectomy.RESULTSThe rate of switching to an alternative thrombectomy after failure of the front-line technique was significantly higher in the CAT group than in the SRT group (40% vs 4.3%; OR 2.543, 95% CI 1.893–3.417, p < 0.001). The median time from puncture to initial reperfusion (17 vs 31 minutes, p < 0.001) and procedure duration (39 vs 75.5 minutes, p < 0.001) were significantly shorter in the SRT group than in the CAT group. In the binary logistic regression analysis, a longer time from puncture to initial reperfusion was an independent predictor of a 90-day poor (modified Rankin Scale score 3–6) functional outcome (per 1-minute increase; OR 1.029, 95% CI 1.008–1.050, p = 0.006).CONCLUSIONSThe authors’ results suggest that SRT may be more effective than CAT for identifying underlying culprit stenosis and therefore considered the optimal front-line thrombectomy technique in acute stroke patients with LVO and severe underlying ICAS.

scholarly journals SUCCESSFUL USE OF INTRACORONARY TENECTEPLASE AS A RESCUE FOR FAILED ASPIRATION THROMBECTOMY IN A PATIENT PRESENTING WITH STEMI

2021 ◽  
Vol 77 (18) ◽  
pp. 2499
Author(s):  
Anubhav Jain ◽  
Ankita Aggarwal ◽  
Ameer Khan ◽  
Mishita Goel ◽  
Zaid Kasmikha
Keyword(s):  
Aspiration Thrombectomy

scholarly journals ROUTINE USE OF ASPIRATION THROMBECTOMY DEVICE “PENUMBRA” IN MYOCARDIAL INFARCTION (ROPUST) STUDY

2021 ◽  
Vol 77 (18) ◽  
pp. 1030
Author(s):  
Ahmad Tarek Chami ◽  
Tony Dong ◽  
Nour Tashtish ◽  
Haytham Mously ◽  
Mehdi Shishehbor ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Aspiration Thrombectomy ◽  
Thrombectomy Device

scholarly journals O-012 Evidence of arterial collapse in a human brain model and in-vivo with aspiration thrombectomy

2021 ◽  
Author(s):  
Y Liu ◽  
D Gebrezgiabhier ◽  
J Arturo Larco ◽  
S Madhani ◽  
A Shahid ◽  
...  
Keyword(s):  
Human Brain ◽  
Aspiration Thrombectomy

Aspiration Thrombectomy with the Indigo System for Acute Lower Limb Ischemia: preliminary experience and analysis of parameters affecting the outcome.

2021 ◽  
Author(s):  
Michele Rossi ◽  
Marcello Andrea Tipaldi ◽  
Francesco Bruno Tagliaferro ◽  
Andrea Pisano ◽  
Edoardo Ronconi ◽  
...  
Keyword(s):  
Lower Limb ◽  
Limb Ischemia ◽  
Aspiration Thrombectomy ◽  
Lower Limb Ischemia

Renal Function Salvage After Delayed Endovascular Revascularization of Acute Renal Artery Occlusion in Patients With Fenestrated-Branched Endovascular Aneurysm Repair or Visceral Debranching

2018 ◽  
Vol 25 (4) ◽  
pp. 466-473 ◽  
Author(s):  
Franziska Heidemann ◽  
Tilo Kölbel ◽  
E. Sebastian Debus ◽  
Holger Diener ◽  
Sebastian W. Carpenter ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Stent Graft ◽  
Aortic Surgery ◽  
Artery Occlusion ◽  
Aspiration Thrombectomy ◽  
Endovascular Revascularization ◽  
Renal Artery Occlusion ◽  
Local Lysis

Purpose: To analyze the renal function and outcome after delayed (>6 hours) endovascular revascularization of acute renal artery occlusion (RAO) in patients with fenestrated-branched endovascular aneurysm repairs (EVARs) or open visceral debranching. Methods: A single-center retrospective analysis was conducted involving 7 patients (mean age 61 years, range 49–72; 5 women) with 9 RAOs treated with endovascular revascularization between December 2014 and March 2017. Three patients had a solitary kidney with chronic renal insufficiency; 1 patient had bilateral occlusions as the acute event. Initial aortic surgery included 5 branched and 1 fenestrated EVAR as well as 1 open visceral debranching operation. Revascularization of the RAO was performed using aspiration thrombectomy, local lysis therapy, and stent-graft relining. The median time between initial aortic surgery and RAO was 10 months (range 0.5–17). Results: Median renal ischemic time to revascularization was 24 hours (range 7–168). Technical success was 100%, with 1 procedure-related access complication. Temporary dialysis dependency occurred in 4 patients. Mean in-hospital stay was 17 days (range 7–32) with 1 postoperative death at day 10 due to cardiac arrest of unknown cause. Mean follow-up was 10.3 months (range 1.5–27) in 5 of 6 discharged patients. During follow-up, 1 reintervention for recurrent occlusion was performed. At follow-up imaging, all renal arteries were patent. No permanent dialysis dependency occurred. Conclusion: Renal function can be salvaged by delayed revascularization for RAO with prolonged renal ischemia. The endovascular approach with aspiration thrombectomy, local lysis, and stent-graft relining is a feasible technique for revascularization after RAO in patients with fenestrated-branched EVAR or open visceral debranching.

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