Effects of percutaneous coronary arterial thrombectomy during acute myocardial infarction on left ventricular remodeling

The benefit. of primary angioplasty for acute myocardial infarction (AMI) is limited by the no-reflow phenomenon, resulting in chronic left. ventricular (LV) remodeling. The aim of this study was to evaluate the impact of, thrombectomy with the Rescue percutaneous thrombectomy catheter on IV function after AMI. We performed a retrospective study comparing conventional angioplasty with the combination of angioplasty and thrombectomy using the Rescue catheter. The study population was comprised of 109 consecutive patients with AMI who underwent angioplasty and thrombectomy and 86 controls treated with. conventional angioplasty. Baseline clinical and lesion characteristics were similar in the 2 groups. Postprocedural restoration of normal flow (Thrombolysis In Myocardial Infarction grade 3) was more frequent in the thrombectomy group (82% vs 69% p = 0.03). No differences were observed in cardiac events, including death, reinfarction, and target vessel revascularization (thrombectomy vs controls, 27% vs 33%; p = 0.44) or changes in ejection fraction (p = 0.22) during 6-month follow-up. The incidence of IV remodeling, defined as an increase in IV end-diastolic,volume index of >20%, was significantly lower in the thrombectomy group (22% vs 44%; p = 0.01). Multiple logistic regression analysis revealed that thrombectomy with the Rescue catheter contributed significantly to reduction of both no-reflow and IV remodeling. In the setting of primary;angioplasty, adjunctive pretreatment with a rescue catheter reduces the no-reflow phenomenon and protects against IV remodeling. (C) 2004 by Excerpta Medica, Inc.