Abstract
The objective of this study was to assess the feasibility, efficacy, and safety of rheolytic thrombectomy (RT) for treatment of coronary stent thrombosis. Stent thrombosis is an infrequent but potentially devastating complication. Conventional treatment with balloon angioplasty and/or thrombolysis has yielded suboptimal results. RT was used to treat 18 patients (mean age, 62 ยฑ 8 years; 72% male) with inโstent thrombosis (mean time to stent thrombosis, 2.4 ยฑ 1.8 days). Device success, procedure success, inโhospital and 30โday major cardiovascular events (MACE) were assessed in the hospital and at 30 days. Device success was obtained in 94% and procedure success was achieved in 100% of patients. Following RT, 11 patients underwent balloon angioplasty and 7 patients received additional stents. TIMI 3 coronary flow was obtained in 94.4% and all (100%) patients achieved either TIMI 2 or 3 coronary flow. The angiographic thrombus area decreased from 113.7 ยฑ 79 to 5.5 ยฑ 5.7 mm^2^ after RT, and to 0.9 ยฑ 2.1 mm^2^ (P < 0.001) after final treatment. Procedural complications were limited to transient noโreflow in five patients. Only one patient evolved a Qโwave MI. At 30 days of followโup, no patients suffered death, emergent bypass surgery, or stroke. Our data suggest that the adjunctive use of rheolytic thrombectomy offers improved outcomes compared to prior results of intervention after coronary stent thrombosis and should be strongly considered as a treatment option for this complication. Cathet Cardiovasc Intervent 2003;58:11โ17. ยฉ 2003 WileyโLiss, Inc.