Coronary Artery DiseaseThrombectomy with AngioJet catheter in native coronary arteries for patients with acute or recent myocardial infarction
Section snippets
Patient population
The study protocol was approved by the institutional review board of Kokura Memorial Hospital. Possible risks and benefits of this device were fully explained to each patient and written consent was obtained. Between November 1996 and November 1997, AngioJet thrombectomy was performed in 31 patients with 31 native coronary artery lesions. All lesions were de novo and no patient had undergone previous percutaneous intervention or coronary artery bypass surgery. Indications for using AngioJet
Patient and lesion characteristics
The baseline characteristics of patients and lesions are listed in Table I. In the 28 patients with acute MI, the time interval from onset of symptoms to emergent catheterization was <12 hours in 18 patients, within 24 hours in 2 patients, within 48 hours in 3 patients, and within 7 days in 5 patients.
Procedure success
Of the 31 patients receiving AngioJet, the procedure was planned in 28 (90%), and in 3 it was used to bail out no-reflow after balloon angioplasty. Procedural success was achieved in all 28
Relative benefits of AngioJet thrombectomy
The thrombotic pathogenesis of MI has been widely accepted,1 and therefore thrombolytic therapy with lytic agents is a logical approach. Thrombolysis with tissue plasminogen activator has been reported to be unsuccessful in recanalizing the occluded vessel in about 20% of patients.19 This has resulted in increasing interest in angioplasty, which has been reported to be superior to thrombolysis in a randomized trial,20 but the presence of thrombus was identified as a predictor of unfavorable
Acknowledgements
We would like to thank the cardiac catheterization laboratory staff for their excellent patient care. We are also indebted to Alfonso-T Miyamoto, MD, for his help with the manuscript.
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