Abstract 213: Retrieval of Plaque Debris by Aspiration Thrombectomy is the Sign of High Risk for Distal Embolization in Acute Coronary Syndrome Patients
Background: Slow flow or no re-flow phenomenon during coronary intervention is mainly caused by distal embolization of thrombus and plaque debris, and is associated with unfavorable long-term clinical outcomes. However, its high-risk patients are not well understood. Aspiration thrombectomy in the patients with acute coronary syndrome (ACS) often retrieves thrombus but sometimes plaque debris. Therefore, we examined if the ACS patients in whom plaque debris was retrieved by aspiration thrombectomy were high-risk of distal embolization.
Methods: Consecutive patients with ACS (n=151) who received aspiration thrombectomy and coronary intervention with filter-type distal protection device (Filtrap) were prospectively enrolled. We classified them into two groups according to whether (Group A, n=29) or not (Group B, n=122) the plaque debris was retrieved by aspiration thrombectomy. We compared between the groups the frequency of filter slow flow/ no-reflow phenomenon and the frequency of distal embolization captured by filter device.
Results: Distal embolization of plaque debris was detected more frequently in Group A than in Group B (90% vs. 30%, P<0.0001). Filter slow flow/ no-reflow phenomenon occurred more frequently in Group A than in Group B (93% vs. 29%, P<0.0001).
Conclusion: Retrieval of plaque debris by aspiration thrombectomy is the sign of high risk for distal embolization in ACS patients. Distal protection may potentially be useful for those high-risk patients.
- © 2013 by American Heart Association, Inc.