Systematic primary aspiration in acute myocardial percutaneous intervention: a multicentre randomised controlled trial of the export aspiration catheter
| العنوان: | Systematic primary aspiration in acute myocardial percutaneous intervention: a multicentre randomised controlled trial of the export aspiration catheter |
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| المؤلفون: | Martine Gilard, Bernard Chevalier, Antonio L. Bartorelli, Michel Hanssen, Thierry Lefèvre, John Roosen, Keyur Parikh, Irene Lang, Didier Carrié, Philippe Commeau, Gilles Montalescot |
| المساهمون: | Institut de Chimie de la Matière Condensée de Bordeaux (ICMCB), Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut Polytechnique de Bordeaux-Université de Bordeaux (UB), Optimisation des régulations physiologiques (ORPHY (EA 4324)), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Privé Beauregard. (CHPB), Centre hopitalier Privé, Département Electronique et Physique (EPH), Institut Mines-Télécom [Paris] (IMT)-Télécom SudParis (TSP), Services répartis, Architectures, MOdélisation, Validation, Administration des Réseaux (SAMOVAR), Centre National de la Recherche Scientifique (CNRS), Department of Cardiology, University Hospital of Rangueil, Faculté de médecine, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP) |
| المصدر: | EuroIntervention EuroIntervention, EuroPCR, 2008, 4 (2), pp.222-8 Scopus-Elsevier Europe PubMed Central |
| بيانات النشر: | HAL CCSD, 2008. |
| سنة النشر: | 2008 |
| مصطلحات موضوعية: | Target lesion, Male, Percutaneous, medicine.medical_treatment, Embolism, Myocardial Infarction, Coronary Disease, 030204 cardiovascular system & hematology, MESH: Catheterization, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Clinical endpoint, 030212 general & internal medicine, Myocardial infarction, Angioplasty, Balloon, Coronary, MESH: Treatment Outcome, MESH: Aged, MESH: Middle Aged, MESH: Suction, Middle Aged, MESH: Angioplasty, Balloon, Coronary, Catheter, MESH: Myocardial Infarction, Treatment Outcome, surgical procedures, operative, Female, Stents, Cardiology and Cardiovascular Medicine, TIMI, medicine.medical_specialty, MESH: Coronary Circulation, Suction, Catheterization, 03 medical and health sciences, Angioplasty, Coronary Circulation, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, cardiovascular diseases, Aged, MESH: Humans, business.industry, medicine.disease, equipment and supplies, MESH: Male, Surgery, MESH: Stents, MESH: Coronary Disease, business, MESH: Female, MESH: Embolism |
| الوصف: | International audience; AIMS: It is unclear whether primary aspiration can prevent distal embolisation and thereby improve myocardial perfusion in patients presenting with acute myocardial infarction (AMI) within 12 hours after onset. METHODS AND RESULTS: At 24 centres in Europe and India, 249 AMI patients were randomised to primary aspiration with the Export aspiration catheter (Medtronic Vascular, Santa Rosa, CA, U.S.A.) followed by stenting (N=120) or to conventional stenting without primary aspiration (N=129). There were no significant differences between the 2 groups in baseline characteristics or target lesion TIMI scores. Procedure time was 36.7 +/- 18.0 minutes for primary aspiration followed by stenting versus 34.5 +/- 21.5 minutes for conventional stenting (P=0.08). Debris was obtained by primary aspiration from 85.3% of the arteries. The use of a bailout technique was significantly lower for primary aspiration than for conventional stenting (5.8% vs. 14.7%, P=0.02). For the primary endpoint of the combined rate of myocardial blush grade 3 and/or ST-segment resolution >50% to assess myocardial perfusion, primary aspiration followed by stenting was superior to conventional stenting (85.0% vs. 71.9%, P=0.025). Immediately postprocedure, the rate of myocardial blush grade 3 was 35.8% for primary aspiration followed by stenting versus 25.4% for conventional stenting (P=0.094). At 60 minutes post procedure, the rate of ST-segment resolution >50% was 73.5% for primary aspiration followed by stenting versus 64.8% for conventional stenting (P=0.218). Primary aspiration was also associated with a significantly higher postprocedure corrected TIMI frame count than conventional stenting (20 +/- 14.9 vs. 22.8 +/- 14, P=0.02). At 30 days, there were no differences between the treatments in the rate of major adverse cardiac and cerebral events. CONCLUSIONS: Compared with conventional stenting, primary aspiration with the Export aspiration catheter followed by stenting improved myocardial reperfusion in AMI patients presenting with TIMI flow grade 0 to 1. Further study of primary aspiration involving larger numbers of patients is warranted to assess its effect on longer-term clinical outcome. |
| اللغة: | English |
| تدمد: | 1774-024X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2a6ea1f05ad115739caac896e31aacbf https://hal.univ-brest.fr/hal-00837629 |
| رقم الأكسشن: | edsair.doi.dedup.....2a6ea1f05ad115739caac896e31aacbf |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1774024X |
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