ISSN:
1540-8183
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
Objective: To evaluate the safety and efficacy of the X-SIZER thrombectomy device versus the use of abciximab during primary angioplasty for acute ST-elevation myocardial infarction (STEMI). Design: Retrospective analysis of patients undergoing primary angioplasty for STEMI from October 2000 to December 2002 using the X-SIZER thrombectomy device versus abciximab. Setting: National University Hospital, Singapore. Patients: Out of 79 patients, 44 underwent X-SIZER use, while 35 received adjunct abciximab. Both groups were similarly represented with regards to age, gender, risk factors, target vessel site/diameter, cardiogenic shock, and onset of chest pain to procedure time. The infarct-related artery was occluded in 88.6% in both groups. Interventions: A 2-mm X-SIZER was used in 34/44 (77.3%), while a 1.5-mm device was used in the remainder. Final TIMI 3 flow was obtained in 38/44 (86.4%) in the X-SIZER group compared to 26/35 (74.3%) in the abciximab group (P = 0.175). Main Outcome Measures: Coronary TIMI flow rate, electrocardiogram (ECG) resolution, slow flow/no reflow phenomenon, and patient outcome (death, cardiac failure, or repeat revascularization) at 1 month. Results: ECG resolution and slow flow/no reflow were better in the X-SIZER group (77.3% vs 54.3%, P = 0.031; 9.1% vs 25.7%, P = 0.047, respectively). Patient outcome at 1 month was, however, not significantly different (18.2% vs 17.1%, P = 0.904, respectively, for X-SIZER and abciximab). Conclusion: X-SIZER thrombectomy during primary percutaneous coronary intervention for thrombus-laden STEMI is a safe and effective strategy. When compared to patients receiving abciximab, it was associated with improved ECG resolution, less slow flow/no reflow and a trend to better TIMI 3 flow.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1111/j.1540-8183.2005.00044.x
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