Early Clinical Experience Of ThromCat Thrombectomy Catheter System In Patients With Acute Coronary Syndromes

Objective: To evaluate the clinical efficacy and safety of ThromCat ThrombectomyCatheter System (TTC) in patients with Acute Coronary Syndromes (ACS). Method:A retrospective analysis of early clinical experience of TTC was finished in 14patients with ACS from the period September 2006 to March 2007 in LeipzigHerzzentrum, Germany. Percutaneous coronary intervention (PCI) were operated inthe patients (13 native coronary arteries and one saphenous vein graft) including 7patients with ST-elevation acute myocardial infarction (STEMI) and 5 patients withnon-ST-elevation myocardial infarction (NSTEMI), 2 patients with unstable angina.The primary end point was the success of procedure (TTC reached the target lesionand was successfully activated), TTC Clinical success was either improvingThrombolysis In myocardial infarction trial flow (TIMI flow) by at least one grade orreduce target stenosis by≥25% without major adverse cardiac events after TTC, andmajor adverse cardiac events (MACE) at 30 days were fellowed up. Results: The rateof procedure success was achieved in 78.6% patients (11/14). TTC Clinical successwas achieved in 71.4% (10/14). Adjunctive balloon angioplasty was performed afterThromCat thrombectomy in 6 patients (42.9%). Subsequent stenting after balloonangioplasty was attempted successfully in 13 patients (92.9%) without thromboticcomplications. Finally success (residual diameter stenosis＜50% without majoradverse cardiac events) was achieved in 92.9%(13/14). TIMI flow grading increasedfrom 1.000±1.109 before ThromCat thrombectomy to 2.290±0.726 after it(p＜0.0001), myocardial blush grade (MBG) increased from 0.860±0.8640 beforeThromCat thrombectomy to 1.790±0.579 after it (p＜0.001). ThromCat Systemrupture was present in two patients and acute coronary perforation occured in onepatient. There were no MACE during in-hospital stay and follow-up. Conclusions: The TTC can be used simply, safely and effectively to remove thrombus from thenative coronary artery without severe calcification in patients with ACS. Thrombusremoval might facilitate subsequent PCI safer and uncomplicated in patients with athrombus burden in ACS.