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Clot removal in AMI—worth the hassle?

¹ E & N Hertfordshire NHS Trust and Imperial College, London
² St Mary’s Hospital, London and Imperial College, London

Correspondence to:
Dr D Gorog, E & N Hertfordshire NHS Trust, Welwyn Garden City, Herts AL7 4HQ, UK; d.gorog@imperial.ac.uk

The first 150 words of the full text of this article appear below.

Primary percutaneous coronary intervention (PPCI) is increasingly seen as the treatment of choice in acute myocardial infarction (AMI). Compared with thrombolysis, with PPCI recanalisation of the vessel is almost guaranteed, and, with elimination of the culprit epicardial stenosis, the risk of reocclusion is greatly reduced. There is, however, one advantage to thrombolysis: if it successfully restores epicardial flow, it can penetrate distal to the lesion and lyse further small microthrombi in the downstream myocardial bed. The effects of thrombus embolisation continue to be a problem in patients undergoing PPCI, in whom angiographic evidence of embolisation occurs in up to 15%,¹ and are clearly related to adverse clinical and functional outcome.^{2 3} Once present, angiographic no-reflow, the end result of distal embolisation, is difficult to treat and disheartening for the operator.

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Coronary thrombectomy by retrieval of an open emboli-protection filter device

I Reho, C Gruner, and M Roffi
Heart 2008 94: 274. [Extract] [Full Text] [PDF]