PUBLICATION TITLE:
Initial experience with a novel stent-based mechanical thrombectomy device for management of acute myocardial infarction cases with large thrombus burdenAuthors:
Yuan Zhi, Mehdi Madanchi, Giacomo Maria Cioffi, Julian Brunner, Leah Stutz, Eleonora Gnan, Varis Gjergjizi, Adrian Attinger-Toller, Florim Cuculi & Matthias BossardJournal:
Cardiovascular Intervention and TherapeuticsBackground:
Patients with acute myocardial infarction (AMI) and large thrombus burden (LTB) still represent a challenge. Afflicted patients have a high morbidity and mortality. Aspiration thrombectomy is often ineffective in those cases. Mechanical thrombectomy devices (MTDs), which are effective for management of ischemic strokes, were recently CE-approved for treatment of thrombotic coronary lesions. Real-world data about their performance in AMI cases with LTB are scarce. This study sought to summarize our early experience with a novel MTD device in this context.Methods:
We analysed consecutive patients from the prospective OPTIMISER registry (NCT04988672), who have been managed with the NeVa™ MTD (Vesalio, USA) for AMI with LTB at a tertiary cardiology facility. Outcomes of interest included, among others, periprocedural complications, target lesion failure (TLF), target lesion revascularization (TLR) and target vessel myocardial infarction (TV-MI).
RESULTS:
Overall, 15 patients underwent thrombectomy with the NeVa™ (enVast™) device. Thrombectomy was successfully performed in 14 (93%) patients. Final TIMI 3 flow was achieved in 13 (87%) patients, while 2 (13%) patients had TIMI 2 flow. We encountered no relevant periprocedural complications, especially no stroke, stent thrombosis or vessel closure. After a mean follow-up time of 26 ± 2.9 months, 1 (7%) patient presented with TLR due to stent thrombosis (10 months after treatment with the MTD and stenting).Conclusions:
In AMI patients with LTB, the deployment of the novel NeVa™ (enVast™) MTD seems efficient and safe. Further randomized trials are warranted to assess whether the use of the NeVa™ device in cases with LTB improves procedural and clinical outcomes.Management of AMI with large thrombus burden using the enVast™ device:
