Thrombectomy with rescue aspiration catheter and distal protection with EPI filterwire in primary angioplasty for acute myocardial infarction

Abstract

AMI (Acute Myocardial Infarction) is usually caused by abrupt plague rupture followed by thrombus formation inside the coronary artery. Primary angioplasty for heavy thrombus loaded vessels may be complicated by distal embolization, leading to no reflow and myocardial damage. We present a case of acute thrombotic occlusion of the left anterior descending artery (LAD), in which we performed simultaneous thrombus removal by the rescue aspiration thrombectomy catheter together with an EPI FilterWire for distal protection against embolization. The lesion was successfully stented with excellent perfusion to the distal capillaries. A huge load of debris (red and white) was retrieved by both devices. The patient remained asymptomatic at 9 months. This case illustrates the possible DUAL protective roles of Aspiration Thrombectomy and Filtering devices in high risk angioplasty for AMI patients.