• Cardiovasc Revasc Med · Sep 2013

    Multicenter Study

    Intracoronary glycoprotein IIb/IIIa inhibitor infusion via a perfusion coronary catheter to decrease thrombus burden: results from the ClearWay™ Multicenter Registry.

    • Gabriel Maluenda, Byron C Sizemore, George Revtyak, Nick Cavros, Bradley B McElroy, Dilip S Arora, Al Deibele, Satyaprakash Makam, Itsik Ben-Dor, Rebecca Torguson, Ron Waksman, and Clearway Registry Investigators.
    • Washington Hospital Center, Washington, DC 20010, USA.
    • Cardiovasc Revasc Med. 2013 Sep 1;14(5):280-3.

    ObjectivesThis multicenter registry aimed to assess the ClearWay™ (CW) perfusion catheter in reduction of thrombus burden and improvement of the coronary flow during percutaneous coronary intervention (PCI).BackgroundThe presence or development of thrombus during PCI is associated with poor prognosis.MethodsThe utility of the CW perfusion catheter was assessed in patients who presented with intracoronary thrombus and were subjected to PCI. Data were collected by online survey from 15 US sites. Angiographic assessment of the coronary thrombus burden and the coronary flow after intracoronary infusion of glycoprotein (GP) IIb/IIIa inhibitors via the CW catheter was evaluated at baseline, immediately after infusion, and at the end of the procedure. The cohort included 102 patients; 71.6% presented with ST-elevation myocardial infarction (MI), 21.6% with non-ST-elevation MI, 5.9% with stable angina pectoris, and 2.9% with silent ischemia. The mean cohort age was 59.9±14.5years and comprised mostly of men (72.5%).ResultsGP IIb/IIIa inhibitors were infused via the CW catheter on average 1.1±0.3 times, with a mean pressure of 4.2±2.7atm and a mean infusion time of 55±55s. Following the infusion, Thrombolysis In Myocardial Infarction (TIMI) flow improved by 1° in 71 patients (69.6%) and by 2° in 51 patients (50%), while visible thrombus was reduced by 52% (p<0.001). In the final angiogram, TIMI flow was restored in 90.2% and clearance of a visible thrombus was obtained in 91.8% of the lesions.ConclusionIntracoronary infusion of GP IIb/IIIa inhibitors via the perfusion CW catheter is associated with significant reduction in thrombus burden and with improvement of the coronary flow in patients presenting or developing thrombus burden during PCI.Copyright © 2013. Published by Elsevier Inc.

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