Amoroso G - AIMRADIAL 2015 - Thrombectomy and radial approach
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Transcript of Amoroso G - AIMRADIAL 2015 - Thrombectomy and radial approach
5Fr-compatible thrombosuction in STEMI
G. AmorosoOLVG Amsterdam, The Netherlands
« I have no conflicts of interest to discloseregarding this presentation »
Do we need 5 Fr
How aggressive should thrombosuction be
For many patient is the radial artery smaller than a 6Fr introducer
Downsizing is an effective way to prevent radial occlusion
S Jolly, NEJM 2015
TOTAL Trial Flow and Adherence
S Jolly, NEJM 2015
(CV death, re MI, shock, HF NYHA IV)
S Jolly, NEJM 2015
Subgroup Analysis Primary Outcome
PJ Vlaar, JACC Cardiovasc Int 2008
Diver Invatec = ID 0.062”
Export Medtronic = ID 0.041”
Bigger aspiration area do not achieve better results
Vmax – Stron MedicalEmax - TsunaMed
Export - Medtronic
Pronto LP – Vascular Solutions
5Fr compatible
5.2 Fr compatible
6 Fr compatible
Different tip shapes of aspiration catheters
VMax
EMax
# Case 1
Female, 71 yrs. old, Posterior STEMI GC MM JL 3.5 sheathless 5Fr
Sion Asahi GW, Vmax aspiration catheter
LPL lesion
Direct stenting DES 3.0/18 + 3.0/9, Biotronik Orsiro
Final Result
# Case 2
Male, 71 yrs old, inferior STEMI GC MM JL 3.5 sheathless 5Fr
Occluded RCA distal
Asahi Sion GW, Emax aspiration catheter
Visible (white) thrombus retrieved
Deep seating GC
DES 3.0/18 (Biotronik Orsiro)
Final Result
Conclusions
• 5Fr compatible thrombosuction is feasible in selected patients undergoing primary PCI.
• A patient-tailored “Slender” approach with ad-hoc thrombosuction may be the preferred strategy in STEMI