Clinical Experiences with the Percusurge(r) for the Coronary Lesions with Intracoronary Thrombus.
10.4070/kcj.2002.32.5.407
- Author:
Hyun Joong KIM
1
;
Hyeon Cheol GWON
;
Ji Chang YOON
;
Ho Hyun LEE
;
Kyung Hun WON
;
Sang Hoon LEE
;
Kyung Pyo HONG
;
Jeong Euy PARK
;
Jung Don SEO
Author Information
1. Cardiac Center, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Protection devices;
Coronary thrombosis;
Angioplasty;
transluminal;
percutaneous coronary
- MeSH:
Angina, Stable;
Angioplasty;
Biomarkers;
Coronary Thrombosis;
Coronary Vessels;
Diagnosis;
Humans;
Mortality;
Myocardial Infarction;
Saphenous Vein;
Thrombosis*;
Transplants
- From:Korean Circulation Journal
2002;32(5):407-412
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: During coronary angioplasty, a distal embolization of the intracoronary thrombus is associated with an increased risk of myocardial infarction and mortality. Recently, distal protection devices have been tested for distal embolization with varying success. Here we report the experiences with one of the distal protection devices, Percusurge(r). SUBJECTS AND METHODS: From January 2001 to August 2001, 5 cases of a Percusurge(r) being used in patients with intracoronary thrombus were experienced during the angioplasty (male:4, female:1). Both the pre- and post-procedural clinical findings of the patients, the angiographic findings, the number of acute complications, the presence of biochemical marker such as CK-MB, and any in-hospital cardiac events were reviewed. RESULTS: Percusurge(r) was used in the right coronary artery (RCA) in 4 cases and in the saphenous vein graft in 1. The clinical diagnosis included stable angina (2 patients), non-Q wave myocardial infarction (1 patient), and Q-wave myocardial infarction (2 patients). The patients showed a TIMI 0 or 1 flow in 4 patients with a RCA lesion and TIMI 3 flow in 1 patient with a saphenous vein graft lesion. However, the TIMI 3 flow was recovered in all cases after the intervention. The CK-MB level did not show any significant changes between the pre- and post-procedure in 4 cases (11.2 +/- 3.2 U/L vs 10.2 +/- 2.1 U/L). However, one of the distal branchs was totally occluded by the distal embolization of the thrombus, and the CK-MB level increased from 2.1 U/L to 22.7 U/L. Otherwise, no procedure-related complications or major in-hospital cardiac events were observed. CONCLUSION: The use of the distal protection device, Percusurge(r), may reduce both the procedural and clinical complications during a coronary intervention in the thrombus-containing lesion. However, a large prospective study is needed to define the role of the distal protection device.
