TY - JOUR
T1 - Detection of embolic particles with the Doppler guide wire during coronary intervention in patients with acute myocardial infarction
T2 - Efficacy of distal protection device
AU - Okamura, Atsunori
AU - Ito, Hiroshi
AU - Iwakura, Katsuomi
AU - Kawano, Shigeo
AU - Inoue, Koichi
AU - Maekawa, Yoshihiro
AU - Ogihara, Toshio
AU - Fujii, Kenshi
N1 - Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2005/1/18
Y1 - 2005/1/18
N2 - We investigated whether embolic particles could be detected as high-intensity transient signals (HITS) with a Doppler guide wire during percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) We also assessed whether these signals could be reduced using a distal protection (DP) device. Embolization of thrombi and plaque components to the microcirculation is a major complication of PCI in patients with AMI. Embolic particles running in the cerebral artery are detected as HITS by transcranial Doppler ultrasound. We prospectively studied 16 consecutive patients with AMI who underwent direct PCI within 24 h after the onset of symptoms. A PercuSurge GuardWire (MedtronicAVE, Santa Rosa, California) was used as the DP device. Eight patients were randomly assigned to the non-DP group, and the remaining eight were assigned to the DP group. Coronary flow velocity was recorded continuously from before the first balloon inflation to after balloon deflation. All patients in the non-DP group had HITS detected (12 ± 9 counts) within five consecutive beats (4 ± 1 beat) after balloon deflation, but none were detected in any of the patients in the DP group. The Doppler guide wire can be used to visually detect and count emboli as HITS, and the DP device is effective for prevention of distal embolization.
AB - We investigated whether embolic particles could be detected as high-intensity transient signals (HITS) with a Doppler guide wire during percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) We also assessed whether these signals could be reduced using a distal protection (DP) device. Embolization of thrombi and plaque components to the microcirculation is a major complication of PCI in patients with AMI. Embolic particles running in the cerebral artery are detected as HITS by transcranial Doppler ultrasound. We prospectively studied 16 consecutive patients with AMI who underwent direct PCI within 24 h after the onset of symptoms. A PercuSurge GuardWire (MedtronicAVE, Santa Rosa, California) was used as the DP device. Eight patients were randomly assigned to the non-DP group, and the remaining eight were assigned to the DP group. Coronary flow velocity was recorded continuously from before the first balloon inflation to after balloon deflation. All patients in the non-DP group had HITS detected (12 ± 9 counts) within five consecutive beats (4 ± 1 beat) after balloon deflation, but none were detected in any of the patients in the DP group. The Doppler guide wire can be used to visually detect and count emboli as HITS, and the DP device is effective for prevention of distal embolization.
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U2 - 10.1016/j.jacc.2004.09.062
DO - 10.1016/j.jacc.2004.09.062
M3 - Article
C2 - 15653017
AN - SCOPUS:11844258888
VL - 45
SP - 212
EP - 215
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 2
ER -