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20.06.2018 | Original articles

Predictors of angiographically visible distal embolization in STEMI

verfasst von: N. V. Yaméogo, MD, PhD, C. Guenancia, MD PhD, G. Porot, MD, K. Stamboul, MD PhD, C. Richard, MD PhD, A. Gudjoncik, MD PhD, J. Hamblin, MD, P. Buffet, MD, L. Lorgis, MD PhD, Y. Cottin, MD PhD

Erschienen in: Herz | Ausgabe 3/2020

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Abstract

Background

Distal embolization during primary percutaneous coronary intervention (p-PCI) in the treatment of ST-segment elevation myocardial infarction (STEMI) is associated with a poor prognosis. In this situation, thrombectomy is performed to prevent distal embolization and to restore myocardial reperfusion. The aim of our study was to determine angiographic predictors of angiographically visible distal embolization (AVDE) in patients with STEMI treated by p‑PCI with thrombectomy.

Patients and methods

This prospective study included all consecutive patients who underwent p‑PCI with thrombectomy for STEMI at our institution between October 2011 and December 2014 AVDE was defined as a distal filling defect with an abrupt cut-off in one of the peripheral coronary branches of the infarct-related artery, distal to the angioplasty site. Thrombectomy was considered positive when it removed thrombi, and successful when it improved coronary flow.

Results

Among the 346 patients included, 59 (17%) developed AVDE during p‑PCI. In multivariate analysis, the infarct-related right coronary artery (OR: 2.48, 95% CI: 1.36–4.52; p = 0.003) and a culprit lesion diameter of >3 mm (OR : 1.90, 95% CI: 1.01–3.56; p = 0.048) were identified as independent factors associated with AVDE during p‑PCI with thrombectomy for STEMI. The success of thrombectomy and the Syntax score were not associated with AVDE.

Conclusion

AVDE complicating p‑PCI with thrombectomy in STEMI is frequent (17%) and a successful thrombectomy does not rule out AVDE.

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Titel: Predictors of angiographically visible distal embolization in STEMI
verfasst von: N. V. Yaméogo, MD, PhD
C. Guenancia, MD PhD
G. Porot, MD
K. Stamboul, MD PhD
C. Richard, MD PhD
A. Gudjoncik, MD PhD
J. Hamblin, MD
P. Buffet, MD
L. Lorgis, MD PhD
Y. Cottin, MD PhD
Publikationsdatum: 20.06.2018
Verlag: Springer Medizin
Erschienen in: Herz / Ausgabe 3/2020
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-018-4723-1

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Predictors of angiographically visible distal embolization in STEMI

Abstract

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Patients and methods

Results

Conclusion

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Patients and methods

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Conclusion

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