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. 2023 Apr 28;20(4):309-313.
doi: 10.26599/1671-5411.2023.04.003.

How to effectively manage the refractory coronary thrombus? A systemic mini-review

Song Zhang  1 , Dang-Hui Sun  1 , Shuang Li  1 , Yue Li  1   2   3   4   5
Affiliations

How to effectively manage the refractory coronary thrombus? A systemic mini-review

Song Zhang et al. J Geriatr Cardiol. .

Abstract

The main management principle for patients with coronary thrombus should be "more removal and less implantation". Routine thrombus aspiration (TA) is ineffective for intracoronary thrombus or high residual thrombus burden after TA and may result in a refractory coronary thrombus. It is unwise to implant a stent in the vessel with high residual thrombus, which is associated with no-reflow, impaired microvascular perfusion, and consequently worse clinical outcomes. Therefore, increasing the efficiency of TA during percutaneous coronary intervention procedures, especially under some conditions of refractory coronary thrombus, is very important to restore myocardial reperfusion and improve microvascular dysfunction early. In the present work, we aimed to demonstrate the factors that may affect TA efficiency and introduce several highly effective approaches to treat refractory coronary thrombus.

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Figures

Figure 1
Figure 1
The Export AP catheter is used to treat a case of iatrogenic thromboembolism.
Figure 2
Figure 2
The ‘Mother-in-child catheter’ technique is used to treat acute thrombosis in the LM artery.
Figure 3
Figure 3
Demonstration of the ‘3D-shaped’ tip of the second guidewire.
Figure 4
Figure 4
Description of the ‘thrombus aspiration catheter-assisted twisting wire technique’.
See this image and copyright information in PMC

References

    1. Jolly SS, Cairns JA, Yusuf S, et al Randomized trial of primary PCI with or without routine manual thrombectomy. N Engl J Med. 2015;372:1389–1398. doi: 10.1056/NEJMoa1415098. - DOI - PMC - PubMed
    1. Fröbert O, Lagerqvist B, Olivecrona GK, et al Thrombus aspiration during ST-segment elevation myocardial infarction. N Engl J Med. 2013;369:1587–1597. doi: 10.1056/NEJMoa1308789. - DOI - PubMed
    1. Bhindi R, Kajander OA, Jolly SS, et al Culprit lesion thrombus burden after manual thrombectomy or percutaneous coronary intervention-alone in ST-segment elevation myocardial infarction: the optical coherence tomography sub-study of the TOTAL (ThrOmbecTomy versus PCI ALone) trial. Eur Heart J. 2015;36:1892–1900. doi: 10.1093/eurheartj/ehv176. - DOI - PMC - PubMed
    1. Vlaar PJ, de Smet BJ, van den Heuvel AF, et al Operator dependence of outcome after primary percutaneous coronary intervention. EuroIntervention. 2011;6:760–767. doi: 10.4244/EIJV6I6A129. - DOI - PubMed
    1. Higuma T, Soeda T, Yamada M, et al Does residual thrombus after aspiration thrombectomy affect the outcome of primary PCI in patients with ST-segment elevation myocardial infarction? An optical coherence tomography study. JACC Cardiovasc Interv. 2016;9:2002–2011. doi: 10.1016/j.jcin.2016.06.050. - DOI - PubMed

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