1/6. Acute thrombotic-ischemic coronary syndromes: the usefulness of TEC.Transluminal extraction catheter (TEC) is a percutaneous device that performs simultaneous thrombus aspiration and plaque excision. Clinical indications for its application are acute myocardial infarction, unstable angina, and stable angina caused by atherosclerotic, thrombotic lesions located within native coronary arteries and degenerated saphenous vein grafts. The device is useful in management of ischemic patients with contraindications to either pharmacologic thrombolytics or platelet GPIIb/IIIa receptor inhibitors, and can also effectively be used in combination with these agents. A successful TEC procedure requires careful patient selection, strict adherence to recommended indications, optimal equipment selection, familiarity with mechanical components of the device, full understanding of safe and efficacious techniques for deployment and activation, as well as recognition of unique associated angiographic manifestations such as the "empty-pouch phenomenon." As with other debulking devices, the incidence of restenosis post-TEC appears to be directly related to acute luminal gain at the time of procedure and therefore requires the need for adjunct stenting. This communication describes and illustrates various clinical, technical, and angiographic aspects of TEC procedure in patients with acute ischemic-thrombotic coronary syndromes. Cathet. Cardiovasc. Intervent. 48:406-420, 1999.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/6. Transluminal extraction catheter atherectomy for the treatment of acute occlusion of an ectatic coronary artery.Thrombotic occlusion of an ectatic coronary artery may not respond to thrombolytic therapy or balloon angioplasty, since the infarct-related vessel contains a significant amount of thrombus. A patient with acute myocardial infarction of an ectatic right coronary artery that was occluded by a heavy clot burden is described. The patient was treated successfully with transluminal extraction catheter atherectomy and results were confirmed by intravascular ultrasound.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
3/6. thrombectomy with rescue percutaneous thrombectomy catheter: our initial experience.Plaque rupture and subsequent thrombus formation inside the coronary arteries has been known for years. Mechanical devices have been used for the extraction or dissolution of thrombus inside the coronary arteries. This report illustrates the use of the Rescue Percutaneous thrombectomy Catheter in a right coronary artery loaded with thrombus. Following thrombectomy, the stenosis in the artery was well delineated. Successful balloon angioplasty was performed, which resulted in TIMI 3 flow and no distal embolization. Rescue Percutaneous thrombectomy Catheter has been successfully used in the setting of acute myocardial infarction. The present case illustrates that the Rescue Percutaneous thrombectomy Catheter can be used for removing thrombus even one month after acute myocardial infarction.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/6. Power thrombectomy in acute ischemic coronary syndromes.Intracoronary thrombi are commonly found in patients with acute coronary syndromes. A large thrombus burden or a platelet-rich thrombus frequently resists pharmacologic therapy ("thrombolytic ceiling"). In such cases restoration of adequate antegrade coronary flow necessitates application of a mechanical force. Power thrombectomy is a revascularization strategy incorporating a mechanical device for removal of occlusive coronary thrombi in conjunction with or following administration of either platelet glycoprotein IIb/IIIa receptor inhibitors or thrombolytic agents, or both. Mechanical devices for power thrombectomy include ultrasound sonication, rheolytic thrombectomy (Angiojet), laser, transluminal extraction catheter, aspiration catheter, and to a limited extent, balloon angioplasty. In acute coronary syndromes the strategy of power thrombectomy aims to achieve the clinical advantages of more nearly complete vessel patency, improved antegrade flow, and enhanced preservation of myocardial tissue.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/6. Usefulness of a 6 fr right judkins catheter for mechanically extracting a massive intracoronary thrombus from an ectasic right coronary artery: a report on two different cases of thrombectomy.In order to bail out the slow-flow phenomenon (slow flow) created by a massive thrombus in an ectasic right coronary artery, a thrombus was mechanically extracted with a 6 Fr right Judkins (JR) catheter, which proved to be more useful than a usual thrombectomy using a Rescue PT system catheter (Rescue). In case 1, the Rescue was used in combination with thrombolysis but failed to alleviate the slow flow that was implicated in a large infarction. On the other hand, in case 2, aggressive thrombectomy with a 6 Fr JR catheter with an 8 Fr Amplatz guiding catheter successfully extracted the massive intracoronary thrombus, restoring good coronary flow. Therefore, mechanical extraction with a 6 Fr JR catheter is safe and useful in cases of massive thrombus when diffuse coronary artery ectasia complicates an acute myocardial infarction. In addition, this method should be applicable to cases of acute coronary syndrome with massive thrombus.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/6. Novel method for extraction of a massive refractory coronary thrombus after stent implantation.Percutaneous treatment of thrombotic coronary lesions is associated with an increased incidence of complications. In particular, management of massive coronary thrombus refractory to traditional methods of removal may be especially problematic. We report a novel application of the FilterWire distal protection device to retrieve a massive refractory native coronary thrombus present after drug-eluting stent implantation.- - - - - - - - - - ranking = 4keywords = extraction (Clic here for more details about this article) |