Dr.S.Venkatesan MD

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Fine art of thrombus suction in STEMI !

February 29, 2012 5:26 pm

The key word for  successful  primary PCI  is

•  Suction &  Aspiration of thrombus  with   micro catheters like  export catheters
• One can do away with a stent during primary PCI but can never do away aspiration
• Distal protection as concept is rapidly dying out as we aim to remove all the thrombus .

Tips for effective thrombus aspiration

• Apply continuous negative pressure once catheter reaches the thrombus do not release  it till you enter back into the guide.
• Make sure  you are sucking only  blood  products  not the  endothelium
• Watch out for  side branch spill over.
• 7F sheath 7F catheter ideal for aspirating  with a  micro catheter
• Please be informed some thrombus require more negative pressure especially  in the late  presenters of STEMI

* During dire emergency when you do not have a specialized suction catheter do not hesitate to push  even a diagnostic catheter into the coronary .We have  saved few lives !

Crazy   questions  in primary PCI  ( or Is  it futuristic )

Can we connect the suction apparatus into LAD micro catheter ?

Do we have camera guided suction catheter ?

Can you flush the thrombus if you are not succeeding in aspiration ?

Is ultrasonic desiccation  of thrombus possible ?

Acknowledgement

Some of the tips were  gathered from the recently concluded  India Live  2012  conference   in New Delhi .

Posted by dr s venkatesan

Categories: Cardiology -Interventional -PCI, cardiology -Therapeutics, cardiology- coronary care

Tags: export catheter, primary pci, thrombo suction, thrombus aspiration, tornus catheter

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