Efficacy of Embolic Protection using PercuSurge GuardWire System During Primary Percutaneous Coronary Intervention with the Lesions Suggesting Large Thrombus Burden

ABSTRACT

BACKGROUND AND OBJECTIVES: We evaluated the efficacy of embolic protection using the PercuSurge GuardWire (PSG) system during primary percutaneous coronary intervention (PCI) on lesions with angiographic features suggesting large thrombus burden of the infarct-related artery (IRA). SUBJECTS AND METHODS: Between June 2002 and May 2003, we enrolled 30 patients who underwent primary PCI with angiographic features suggesting large IRA thrombus burden (abrupt end occlusive pattern, persistent dye stasis, reference diameter >4 mm, floating thrombus, accumulated thrombus >5 mm). Fourteen patients received primary PCI with the PSG system (PSG group) and 16 received primary PCI without the PSG system (control group). We compared angiographic results (TIMI flow, myocardial blush grade) and > or =50% resolution of ST segment elevation at 2 hours after reperfusion. RESULTS: Baseline clinical and angiographic characteristics were not significantly different between the two groups. Primary PCI with the PSG system was performed successfully in all patients. Post PCI TIMI grade 3 flow and myocardial blush grade 3 were achieved significantly more often in the PSG group (100% vs. 69%, p=0.022; 57% vs. 6%, p=0.004, respectively). Resolution of ST-segment elevation > or =50% was observed significantly more often in the PSG group (79% vs. 31%, p=0.01). CONCLUSION: Primary PCI with the PercuSurge GuardWire system might improve coronary blood flow and micro-vascular circulation in patients with angiographic features suggesting large thrombus burden.