PMID- 29275878
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20181211
IS  - 1916-7075 (Electronic)
IS  - 0828-282X (Linking)
VI  - 34
IP  - 1
DP  - 2018 Jan
TI  - Microcatheter-Facilitated Primary Angioplasty in ST-Segment Elevation Myocardial 
      Infarction.
PG  - 23-30
LID - S0828-282X(17)31154-6 [pii]
LID - 10.1016/j.cjca.2017.11.005 [doi]
AB  - BACKGROUND: Direct stenting is the best method for achieving reperfusion in
      primary percutaneous coronary intervention (PPCI). We hypothesized that the use
      of a microcatheter (MC) during PPCI when Thrombolysis in Myocardial Infarction
      (TIMI) flow </= 1 after wire crossing would allow visualization of the downstream
      artery with an optimal TIMI 3 flow at the end of the procedure. METHODS: In this 
      pilot study, PPCI patients with TIMI flow </= 1 after wire crossing formed the MC
      group (n = 60); the MC was positioned in the distal part of the culprit artery
      and a small amount of contrast was injected through it to determine stent size
      and length to treat the culprit lesion. The MC group was compared with previous
      consecutive patients treated using standard PPCI (n = 94; similar characteristics
      except for the rate of previous percutaneous coronary intervention). RESULTS: In 
      the MC group, downstream arteries were visualized in 98% of cases and direct
      stenting was achieved in 72% vs 31% (P < 0.0001). Final TIMI 3 flow was similar
      in both groups (97%). There was less manual thrombectomy (20% vs 63%; P < 0.001) 
      and bailout glycoprotein IIb/IIIa inhibitor use (6.7% vs 29.8%; P < 0.002). The
      incidence of major adverse events (death, shock, severe arrhythmia) and left
      ventricular ejection fraction were similar. The peak cardiac enzymes level was
      significantly lower in the MC group. CONCLUSIONS: The MC strategy appears
      feasible and safe. It could allow exploring new strategies on the basis of more
      systematic direct stenting and prepared reperfusion by injecting drugs through
      the MC before reperfusion.
CI  - Copyright (c) 2017 Canadian Cardiovascular Society. Published by Elsevier Inc.
      All rights reserved.
FAU - Achkouty, Guy
AU  - Achkouty G
AD  - Department of Cardiology, Lariboisiere Hospital, Assistance Publique-Hopitaux de 
      Paris, Paris Diderot University, Paris, France.
FAU - Dillinger, Jean-Guillaume
AU  - Dillinger JG
AD  - Department of Cardiology, Lariboisiere Hospital, Assistance Publique-Hopitaux de 
      Paris, Paris Diderot University, Paris, France.
FAU - Sideris, Georgios
AU  - Sideris G
AD  - Department of Cardiology, Lariboisiere Hospital, Assistance Publique-Hopitaux de 
      Paris, Paris Diderot University, Paris, France.
FAU - Manzo-Silberman, Stephane
AU  - Manzo-Silberman S
AD  - Department of Cardiology, Lariboisiere Hospital, Assistance Publique-Hopitaux de 
      Paris, Paris Diderot University, Paris, France.
FAU - Voicu, Sebastian
AU  - Voicu S
AD  - Department of Cardiology, Lariboisiere Hospital, Assistance Publique-Hopitaux de 
      Paris, Paris Diderot University, Paris, France.
FAU - Merat, Benoit
AU  - Merat B
AD  - Department of Cardiology, Lariboisiere Hospital, Assistance Publique-Hopitaux de 
      Paris, Paris Diderot University, Paris, France.
FAU - Logeart, Damien
AU  - Logeart D
AD  - Department of Cardiology, Lariboisiere Hospital, Assistance Publique-Hopitaux de 
      Paris, Paris Diderot University, Paris, France.
FAU - Henry, Patrick
AU  - Henry P
AD  - Department of Cardiology, Lariboisiere Hospital, Assistance Publique-Hopitaux de 
      Paris, Paris Diderot University, Paris, France. Electronic address:
      patrick.henry@aphp.fr.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - England
TA  - Can J Cardiol
JT  - The Canadian journal of cardiology
JID - 8510280
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - 0 (Troponin I)
RN  - EC 2.7.3.2 (Creatine Kinase)
SB  - IM
MH  - *Angioplasty, Balloon, Coronary
MH  - Anticoagulants/therapeutic use
MH  - Blood Flow Velocity
MH  - *Cardiac Catheters
MH  - Coronary Circulation
MH  - Creatine Kinase/blood
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Operative Time
MH  - Pilot Projects
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors
MH  - Prospective Studies
MH  - ST Elevation Myocardial Infarction/blood/*therapy
MH  - Stents
MH  - Thrombectomy/statistics & numerical data
MH  - Troponin I/blood
EDAT- 2017/12/26 06:00
MHDA- 2018/12/12 06:00
CRDT- 2017/12/26 06:00
PHST- 2017/07/15 00:00 [received]
PHST- 2017/10/09 00:00 [revised]
PHST- 2017/11/06 00:00 [accepted]
PHST- 2017/12/26 06:00 [entrez]
PHST- 2017/12/26 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
AID - S0828-282X(17)31154-6 [pii]
AID - 10.1016/j.cjca.2017.11.005 [doi]
PST - ppublish
SO  - Can J Cardiol. 2018 Jan;34(1):23-30. doi: 10.1016/j.cjca.2017.11.005.