In:
Catheterization and Cardiovascular Interventions, Wiley, Vol. 88, No. 5 ( 2016-11), p. 716-725
Abstract:
To test whether thrombus aspiration (TA) reduces the atherosclerotic burden in culprit lesions and “facilitate” percutaneous coronary intervention with stent (S‐PCI) among patients with non‐ST elevation acute coronary syndromes (NSTE‐ACS). Background Evidence on the effects of TA adjunctive to S‐PCI in NSTE‐ACS is limited and controversial. Methods TA was defined “aggressive” when using 7F devices or a catheter/artery ratio 〉 0.6, “conservative” with 6F, and a catheter/artery ratio ≤0.6. Angiography and intravascular ultrasound (IVUS) were performed at baseline, after TA and after stent deployment. Results TA was accomplished in 61/76 patients (80%) with NSTE‐ACS. The aspirated material was red thrombus in 23% and plaque fragments in 49% of cases. Compared with baseline, TA was associated with an 82% increase in minimal lumen diameter and a 15% reduction in diameter stenosis ( P 〈 0.001 for both). After TA, IVUS documented a 24 and 16% increase in minimal lumen area and lumen volume, respectively ( P 〈 0.001 for both), a 7% decrease in area stenosis through an 11% reduction of plaque + media volume ( P 〈 0.001). When compared with “conservative”, an “aggressive” TA was associated with a more pronounced reduction in percent area stenosis ( P 〈 0.05) and an increase in percent stent expansion ( P 〈 0.001). The plaque + media volume reduction after TA was correlated with stent expansion ( r = 0.261, P = 0.046). Conclusions Manual TA reduces atherothrombotic burden in culprit lesions of NSTE‐ACS patients before S‐PCI and, when deep plaque removal is obtained, TA optimizes subsequent stent expansion. © 2015 Wiley Periodicals, Inc.
Type of Medium:
Online Resource
ISSN:
1522-1946
,
1522-726X
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
2001555-0
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