Author + information
- Jose Moreu Burgos1,
- Belen Santos Gonzalez2,
- Tomas Canton3,
- Ester Lazaro-Fernandez4,
- Mar Cespedes Mas5,
- Daniel Nuñez Peras6,
- Luis Manuel Hernando Romero7,
- Maria Arjona Arjona8,
- Andres Sanchez Perez9,
- Cristina Martin Sierra10 and
- Luis Rodriguez Padial11
- 1Complejo Hospitalario de Toledo, Toledo, Spain
- 2Toho University Ohashi Medical center
- 3Hospital Virgen de la Salud Toledo, Toledo, Spain
- 4CENTRO HOSPITALARIO DE TOLEDO, BARCELONA, Spain
- 5Toho University Ohashi Medical center
- 6Toho University Ohashi Medical center
- 7Osmania Medical College, Hyderabad, Telangana, India
- 8Toho University Ohashi Medical center
- 9Toho University Ohashi Medical center
- 10Dokuz Eylül University
- 11Toho University Ohashi Medical Center
During primary PCI distal microembolization of thrombus material impair myocardial perfusión in spite of an adequate TIMI 3 flow. There are some evidence about the utilization of aspiration catheter and intravenous abciximab in primary PCI with abundant thrombus burden . Direct intracoronary injection of abciximab get smaller infarct size than intravenous injection.
Aims: The hypothesis of our study are that direct distal injection of abciximab by aspiration catheter will be better than proximal intracoronary injection with reduction in infarct size and microvascular damage quantified by Magnetic resonance (MR) and 6 months mortality. We have developed an interventional, treatment, parallel Assignment, single Blind (Subject), randomized, efficacy study with three branches: one active comparator (intracoronary full bolus dose of abciximab proximal to thrombus occlusion -group A-) and two experimental; half bolus of intracoronary abciximab proximal to thrombus occlusion and the other half distal by aspiration catheter -group B- and distal injection to thrombus occlusion of total bolus dose of abciximab by aspiration catheter -group C-. Patients with STEMI diagnosis were included. The infarct size and the microvascular obstruction were evaluated through MRI. A control study was done after six months to verify if the place of administration of abciximab had influenced with the miocardial recovery.
167 patients wer included in the study. MRI was achieved in 153 during hospital admission: Group A 52 patients (34%), group B 49 patients (32 %) and group C 52 patients (34 %). There were no differences in clinical features betwen them. There were no significant statistical differences between three groups in infarct size (P=0.179), microvascular obstruction (P = 0,351). After six months, only 83 patients were evaluated by RMI, and no statistical differences were finded by RMI analysis. There are not any difference in MACE between de tre groups.
Distal inyection of abciximab is not able to reduce the infarct size or microvascular injury compared to proximal one, quantified during hospital admission and by Magnetic resonance (MRI) after 6 months.
CORONARY: Thrombus / Thrombectomy and Embolic Protection