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Amoroso G - AIMRADIAL 2015 - Thrombectomy and radial approach

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5 French (5Fr) compatible thrombosuction in STEMI ST-segment elevation myocardial infarction (STEMI)

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Amoroso G - AIMRADIAL 2015 - Thrombectomy and radial approach

  1. 1. 5Fr-compatible thrombosuction in STEMI G. Amoroso OLVG Amsterdam, The Netherlands
  2. 2. « I have no conflicts of interest to disclose regarding this presentation »
  3. 3. Do we need 5 Fr How aggressive should thrombosuction be
  4. 4. For many patient is the radial artery smaller than a 6Fr introducer
  5. 5. Downsizing is an effective way to prevent radial occlusion
  6. 6. S Jolly, NEJM 2015 TOTAL Trial Flow and Adherence
  7. 7. S Jolly, NEJM 2015 (CV death, re MI, shock, HF NYHA IV)
  8. 8. S Jolly, NEJM 2015 Subgroup Analysis Primary Outcome
  9. 9. PJ Vlaar, JACC Cardiovasc Int 2008 Diver Invatec = ID 0.062” Export Medtronic = ID 0.041” Bigger aspiration area do not achieve better results
  10. 10. Vmax – Stron Medical Emax - TsunaMed Export - Medtronic Pronto LP – Vascular Solutions 5Fr compatible 5.2 Fr compatible 6 Fr compatible Different tip shapes of aspiration catheters
  11. 11. VMax
  12. 12. EMax
  13. 13. # Case 1 Female, 71 yrs. old, Posterior STEMI GC MM JL 3.5 sheathless 5Fr
  14. 14. Sion Asahi GW, Vmax aspiration catheter
  15. 15. LPL lesion
  16. 16. Direct stenting DES 3.0/18 + 3.0/9, Biotronik Orsiro
  17. 17. Final Result
  18. 18. # Case 2 Male, 71 yrs old, inferior STEMI GC MM JL 3.5 sheathless 5Fr
  19. 19. Occluded RCA distal
  20. 20. Asahi Sion GW, Emax aspiration catheter
  21. 21. Visible (white) thrombus retrieved
  22. 22. Deep seating GC
  23. 23. DES 3.0/18 (Biotronik Orsiro)
  24. 24. Final Result
  25. 25. Conclusions • 5Fr compatible thrombosuction is feasible in selected patients undergoing primary PCI. • A patient-tailored “Slender” approach with ad-hoc thrombosuction may be the preferred strategy in STEMI

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