Treatment of coronary stent thrombosis with rheolytic thrombectomy: Results from a multicenter experience

Silva, Jose A., White, Christopher J., Ramee, Stephen R., Collins, Tyrone J., Jenkins, J. Stephen, Ho, Kalon, Baim, Donald S., Carrozza, Joseph P., Rinfret, Stephane, Setum, Cindy M., Popma, Jeffrey J. and Kuntz, Richard E. (2003) Treatment of coronary stent thrombosis with rheolytic thrombectomy: Results from a multicenter experience. Catheterization and Cardiovascular Interventions, 58 1: 11-17. doi:10.1002/ccd.10385


Author Silva, Jose A.
White, Christopher J.
Ramee, Stephen R.
Collins, Tyrone J.
Jenkins, J. Stephen
Ho, Kalon
Baim, Donald S.
Carrozza, Joseph P.
Rinfret, Stephane
Setum, Cindy M.
Popma, Jeffrey J.
Kuntz, Richard E.
Title Treatment of coronary stent thrombosis with rheolytic thrombectomy: Results from a multicenter experience
Journal name Catheterization and Cardiovascular Interventions   Check publisher's open access policy
ISSN 1522-1946
Publication date 2003-01
Sub-type Article (original research)
DOI 10.1002/ccd.10385
Volume 58
Issue 1
Start page 11
End page 17
Total pages 7
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Language eng
Formatted abstract
The objective of this study was to assess the feasibility, efficacy, and safety of rheolytic thrombectomy (RT) for treatment of coronary stent thrombosis. Stent thrombosis is an infrequent but potentially devastating complication. Conventional treatment with balloon angioplasty and/or thrombolysis has yielded suboptimal results. RT was used to treat 18 patients (mean age, 62 ± 8 years; 72% male) with in-stent thrombosis (mean time to stent thrombosis, 2.4 ± 1.8 days). Device success, procedure success, in-hospital and 30-day major cardiovascular events (MACE) were assessed in the hospital and at 30 days. Device success was obtained in 94% and procedure success was achieved in 100% of patients. Following RT, 11 patients underwent balloon angioplasty and 7 patients received additional stents. TIMI 3 coronary flow was obtained in 94.4% and all (100%) patients achieved either TIMI 2 or 3 coronary flow. The angiographic thrombus area decreased from 113.7 ± 79 to 5.5 ± 5.7 mm2 after RT, and to 0.9 ± 2.1 mm2 (P < 0.001) after final treatment. Procedural complications were limited to transient no-reflow in five patients. Only one patient evolved a Q-wave MI. At 30 days of follow-up, no patients suffered death, emergent bypass surgery, or stroke. Our data suggest that the adjunctive use of rheolytic thrombectomy offers improved outcomes compared to prior results of intervention after coronary stent thrombosis and should be strongly considered as a treatment option for this complication.
Keyword Thrombectomy
Stent
Thrombus
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 10:29:14 EST