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OP-134 [AJC » Percutaneous coronary interventions in acute coronary syndromes] Coronary Artery Thrombectomy Using Solitaire Stent: A Stent Designed for Intracranial Arteries
MARCH 23e26, 2017
O R A L A B S T R A C T S
Table 1 Nitroglycerine mediated endothelial-independent vasodilatation Angiography site mean Radial Artery Diameter Control site mean Radial Artery Diameter
Baseline mean NAV Radial (%) Radial Artery Artery mean Difference Diameter (mm) Diameter (mm)
p
2,35
2,42
7,5
>0,05
2,26
2,46
8,3
>0,05
Measurement of nitroglycerine mediated endothelial-independent vasodilatation of the radial artery 24 hours after Coronary angiography. NAV; Nitroglycerin mediated vasodilatation Table 2 Nitroglycerine mediated endothelial-independent vasodilatation Angiography site Radial Artery Diameter Control site Radial Artery Diameter
Baseline NAV Radial (%) Radial Artery Artery Difference Diameter(mm) Diameter(mm)
p
2,19
2,40
9,1
>0,05
2,27
2,49
9,7
>0,05
Measurement of nitroglycerine mediated endothelial-independent vasodilatation of the radial artery 8 weeks after Coronary angiography. NAV; Nitroglycerin mediated vasodilatation minutes. The radial artery was scanned in the longitudinal section using an HDI 5000 Ultrasound Instrument (Philips Medical Systems, Bothell, WA) with a 5e12 MHz linear array transducer. One experienced sonographer collected all images. Images were digitized from the video output of the ultrasound machine using a frame grabber under control of custom software on a personal computer. Image acquisition was gated with an ECG signal so that images were captured at end diastole in each cardiac cycle. Results: Ten (% 23) patients were excluded because of radial artery occlusion after coronary angiography. Twenty-four hours and 8 weeks after the coronary angiography there were no significant reduction in the nitroglycerine mediated endothelial-independent vasodilatation of the radial artery compared with the control radial artery (p < 0.05). Table I and Table II. Conclusion: Radial coronary angiography has no negative effects on the radial artery muscular layer functions. Keywords: Radial angiography, Radial artery, Radial grafts, Vessel muscular layer
patients. Here, we describe a case of coronary thrombus retrieval with Solitaire stent in a patient with subacute inferior myocardial infarction patient. Case Report: A 62 years old diabetic man was referred to our clinic with dyspnea and postinfarction angina. One week ago he had been presented with acute inferior myocardial infarction to another hospital. Primary percutaneous coronary intervention for right coronary artery had been unsuccessful. On admission to our clinic, his physical finding were suitable with right ventricle infarction and he had postinfarction angina. Electrocardiography demonstrated second degree Type 1 atrioventricular block with Q waves in the inferior leads. Transthoracic echocardiography showed left ventricular inferior wall akinesia and right ventricular dilatation. A coronary angiography was done immediately and revealed total occlusion in the proximal right coronary artery. After multiple balloon angioplasties of the right coronary artery there was not any distal flow (Figure 1A). Considering the high trombus burden we decided to perform thrombectomy using Solitaire stent. A LIRTM 4.2 F aspiration catheter was introduced into the guiding catheter. A 300 mm 0.014’’ wire was advanced into the distal right coronary artery through the LIR catheter. A Rebar microcatheter was advanced through the 0.014’’ wire. At last a 4 mm X 20 mm Solitaire stent was advanced into the right coronary artery crossing total occlusion, through the Rebar catheter (Figure 1B). After pulling back the Rebar catheter the stent was opened and was holded in the occluded segment of coronary artery for 5 minutes. Then the stent was slowly retrieved together with the microcatheter under continuous aspiration through the LIR catheter. TIMI 2 flow was provided(Figure 1C) and than two overlapping bare metal stents (3.5x32 and 4.0X20 mm) were deployed, a TIMI 3 distal flow was accomplished (Figure 1D). The patient had a good recovery and was discharged three days later. Conclusion: In STEMI patients with large thrombus burden Soltaire device may possibly be efficious in improving coronary microcirculation. Keywords: thrombus aspiration, myocardial infarction, solitaire stent
- OP-134 [AJC » Percutaneous coronary interventions in acute coronary syndromes]
Figure 1. A: No distal flow after multiple balloon angioplasties B: Opened Solitaire stent C: Distal Flow after Solitaire retrieval D: Final angiographic image E: Solitaire stent with a small fragment of thrombus.
Coronary Artery Thrombectomy Using Solitaire Stent: A Stent Designed for Intracranial Arteries. Ender Örnek, Emrullah Kızıltunç, Harun Kundi, Mustafa Çetin. Numune E gitim ve Aras¸tırma Hastanesi, Kardiyoloji Klinigi, Ankara.
- OP-135 [AJC » Percutaneous coronary interventions in acute coronary syndromes]
Introduction: Although net clinical benefit of routine administration has not been shown, thrombus aspiration (TA)in ST segment elevational myocardial infarction (STEMI) cases with high intracoronary thrombus burden improves angiographic success. Manuel thrombectomy is the most widely used method for TA in clinical practice. More refined and effective thrombectomy catheters may improve prognosis by reducing the incidence of microvascular obstruction caused by distal embolisation. SolitaireTM FR Revascularization Device (Covidien, Mansfield, MA) is designed for thrombus retrieval in acute ischemic stroke
Assessment Of The Reperfusion Success Using TIMI Frame Score In Cases With Anterior Myocardial Infarction Undergoing Thrombus Aspiration. Sezen Baglan Uzunget, Orhan Maden, Gizem Çelik Çabuk, Eliz Kader Uzel, Mustafa Mücahit Balcı, Zehra Gölbas¸ı. Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey. Background and Aim: Achieving reperfusion is the key target in the treatment of myocardial infarction with acute ST elevation. In our study, we aimed to compare the improvement in coronary blood flow using
e44 The American Journal of Cardiologyâ MARCH 23e26, 2017 13th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
O R A L A B S T R A C T S
Table 1 Nitroglycerine mediated endothelial-independent vasodilatation Angiography site mean Radial Artery Diameter Control site mean Radial Artery Diameter
Baseline mean NAV Radial (%) Radial Artery Artery mean Difference Diameter (mm) Diameter (mm)
p
2,35
2,42
7,5
>0,05
2,26
2,46
8,3
>0,05
Measurement of nitroglycerine mediated endothelial-independent vasodilatation of the radial artery 24 hours after Coronary angiography. NAV; Nitroglycerin mediated vasodilatation Table 2 Nitroglycerine mediated endothelial-independent vasodilatation Angiography site Radial Artery Diameter Control site Radial Artery Diameter
Baseline NAV Radial (%) Radial Artery Artery Difference Diameter(mm) Diameter(mm)
p
2,19
2,40
9,1
>0,05
2,27
2,49
9,7
>0,05
Measurement of nitroglycerine mediated endothelial-independent vasodilatation of the radial artery 8 weeks after Coronary angiography. NAV; Nitroglycerin mediated vasodilatation minutes. The radial artery was scanned in the longitudinal section using an HDI 5000 Ultrasound Instrument (Philips Medical Systems, Bothell, WA) with a 5e12 MHz linear array transducer. One experienced sonographer collected all images. Images were digitized from the video output of the ultrasound machine using a frame grabber under control of custom software on a personal computer. Image acquisition was gated with an ECG signal so that images were captured at end diastole in each cardiac cycle. Results: Ten (% 23) patients were excluded because of radial artery occlusion after coronary angiography. Twenty-four hours and 8 weeks after the coronary angiography there were no significant reduction in the nitroglycerine mediated endothelial-independent vasodilatation of the radial artery compared with the control radial artery (p < 0.05). Table I and Table II. Conclusion: Radial coronary angiography has no negative effects on the radial artery muscular layer functions. Keywords: Radial angiography, Radial artery, Radial grafts, Vessel muscular layer
patients. Here, we describe a case of coronary thrombus retrieval with Solitaire stent in a patient with subacute inferior myocardial infarction patient. Case Report: A 62 years old diabetic man was referred to our clinic with dyspnea and postinfarction angina. One week ago he had been presented with acute inferior myocardial infarction to another hospital. Primary percutaneous coronary intervention for right coronary artery had been unsuccessful. On admission to our clinic, his physical finding were suitable with right ventricle infarction and he had postinfarction angina. Electrocardiography demonstrated second degree Type 1 atrioventricular block with Q waves in the inferior leads. Transthoracic echocardiography showed left ventricular inferior wall akinesia and right ventricular dilatation. A coronary angiography was done immediately and revealed total occlusion in the proximal right coronary artery. After multiple balloon angioplasties of the right coronary artery there was not any distal flow (Figure 1A). Considering the high trombus burden we decided to perform thrombectomy using Solitaire stent. A LIRTM 4.2 F aspiration catheter was introduced into the guiding catheter. A 300 mm 0.014’’ wire was advanced into the distal right coronary artery through the LIR catheter. A Rebar microcatheter was advanced through the 0.014’’ wire. At last a 4 mm X 20 mm Solitaire stent was advanced into the right coronary artery crossing total occlusion, through the Rebar catheter (Figure 1B). After pulling back the Rebar catheter the stent was opened and was holded in the occluded segment of coronary artery for 5 minutes. Then the stent was slowly retrieved together with the microcatheter under continuous aspiration through the LIR catheter. TIMI 2 flow was provided(Figure 1C) and than two overlapping bare metal stents (3.5x32 and 4.0X20 mm) were deployed, a TIMI 3 distal flow was accomplished (Figure 1D). The patient had a good recovery and was discharged three days later. Conclusion: In STEMI patients with large thrombus burden Soltaire device may possibly be efficious in improving coronary microcirculation. Keywords: thrombus aspiration, myocardial infarction, solitaire stent
- OP-134 [AJC » Percutaneous coronary interventions in acute coronary syndromes]
Figure 1. A: No distal flow after multiple balloon angioplasties B: Opened Solitaire stent C: Distal Flow after Solitaire retrieval D: Final angiographic image E: Solitaire stent with a small fragment of thrombus.
Coronary Artery Thrombectomy Using Solitaire Stent: A Stent Designed for Intracranial Arteries. Ender Örnek, Emrullah Kızıltunç, Harun Kundi, Mustafa Çetin. Numune E gitim ve Aras¸tırma Hastanesi, Kardiyoloji Klinigi, Ankara.
- OP-135 [AJC » Percutaneous coronary interventions in acute coronary syndromes]
Introduction: Although net clinical benefit of routine administration has not been shown, thrombus aspiration (TA)in ST segment elevational myocardial infarction (STEMI) cases with high intracoronary thrombus burden improves angiographic success. Manuel thrombectomy is the most widely used method for TA in clinical practice. More refined and effective thrombectomy catheters may improve prognosis by reducing the incidence of microvascular obstruction caused by distal embolisation. SolitaireTM FR Revascularization Device (Covidien, Mansfield, MA) is designed for thrombus retrieval in acute ischemic stroke
Assessment Of The Reperfusion Success Using TIMI Frame Score In Cases With Anterior Myocardial Infarction Undergoing Thrombus Aspiration. Sezen Baglan Uzunget, Orhan Maden, Gizem Çelik Çabuk, Eliz Kader Uzel, Mustafa Mücahit Balcı, Zehra Gölbas¸ı. Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey. Background and Aim: Achieving reperfusion is the key target in the treatment of myocardial infarction with acute ST elevation. In our study, we aimed to compare the improvement in coronary blood flow using
e44 The American Journal of Cardiologyâ MARCH 23e26, 2017 13th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral