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Objectives: The purpose of this study was to assess the feasibility and safety of thrombus‐aspiration through a 5 Fr guiding catheter with transradial approach in acute coronary syndromes. Background: The use of thrombus‐aspirating devices improves myocardial reperfusion but requires at least a 6 Fr guiding catheter. Transradial coronary interventions using a 5 Fr guiding catheter are attractive to reduce bleeding complications. Methods: We retrospectively selected patients presenting acute coronary syndromes with angiographically visible thrombus who underwent thrombus‐aspiration through radial access using a 4 Fr multipurpose catheter in a 5 Fr guiding catheter. We described clinical and angiographic characteristics of the cohort, and the procedure's technique, success and complications. Results: Among the 34 included patients, 29 presented ST‐segment elevation myocardial infarction. Complete resolution of the ST‐segment elevation was effective in 93% of these patients. TIMI flow grade after thrombus‐aspiration was significantly improved compared to baseline TIMI flow grade or after passage of the guidewire (P < 0.001 for both). There was no dissection or perforation but we noted distal embolization in 5 cases probably explained by the high grade of intracoronary thrombus in our cohort. Conclusion: Thrombus‐aspiration through a 5 Fr guiding catheter with transradial approach seems to be safe and effective in selected patients with acute coronary syndrome. This mini‐invasive approach brought the advantages of the transradial access in 5 Fr but also its limitations. (J Interven Cardiol 2012;25:323–329)
Journal of Interventional Cardiology – Wiley
Published: Aug 1, 2012
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