Removing Large Thrombus Prior to DES Implant Improves Outcomes
August 13, 2007 – A study published in the Journal of the American College of Cardiology showed that when AngioJet thrombectomy is used to remove large thrombus before placement of a drug-eluting stent (DES), it is associated with significantly lower rates of subsequent death, repeat heart attack and stent thrombosis.
The work is authored by Dr. George Sianos and colleagues at the ThoraxCenter in Rotterdam, the Netherlands, and appears in the Journal of the American College of cardiology (JACC), volume 50, number 7, dated August 14, 2007. The publication can be viewed on-line at http://content.onlinejacc.org.
Dr. Sianos analyzed 812 consecutive heart attack patients receiving a DES. Twenty-eight percent of the patients had large thrombus that complicated their treatment. These patients had a much higher incidence of serious adverse events out to two years after treatment, compared to the other patients who did not have large thrombus. The important exceptions were patients whose initial large thrombus was removed with AngioJet thrombectomy before stenting: these patients had a low incidence of serious adverse outcomes, similar to those patients with little or no thrombus to begin with. AngioJet thrombectomy was the single most powerful statistical predictor of a good clinical outcome in such patients.
Said Robert G. Dutcher, CEO of Possis Medical, Inc., "This important study demonstrates that unresolved large thrombus is common in acute coronary cases, and that placing a DES without first removing the thrombus contributes significantly to later life-threatening complications, including stent thrombosis. AngioJet thrombectomy lowers this risk by safely converting a clotted vessel that is at high risk for worse clinical outcomes into an un-clotted, low-risk vessel that can be successfully stented. We believe these results offer an important perspective that addresses some of the current uncertainty regarding DES use in higher-risk settings."
According to Dutcher, Dr. Sianos presented these key results at several important medical meetings in the last year, including the October 2006 Transcatheter Cardiovascular Therapeutics Conference in Washington D.C., and the November 2006 annual meeting of the American Heart Association in Chicago.
"Publication in the JACC, a very prestigious peer-reviewed journal, significantly increases the visibility of Dr. Sianos' results to the entire cardiology community. We believe this will have a favorable effect on the treatment choices made by the interventionalists who treat these seriously ill patients," concluded Dutcher.
For more information: http://content.onlinejacc.org