6533b821fe1ef96bd127b868

RESEARCH PRODUCT

0197: Angiographically visible distal embolization is not linked with culprit lesion but with clinical characteristics

Carole RichardYves CottinLuc LorgisIsabelle L’huillierKarim StamboulNobila Valentin YaméogoAurélie Gudjoncik

subject

medicine.medical_specialtybusiness.industrymedicine.medical_treatmentDistal embolizationPercutaneous coronary interventionThrombolysismedicine.diseaseSurgerymedicine.anatomical_structureInternal medicineRight coronary arterymedicine.arteryCulprit lesionConventional PCImedicineCardiologyMyocardial infarctionCardiology and Cardiovascular MedicinebusinessArtery

description

Despite the recent improvements in percutaneous coronary intervention (PCI), angiographically visible distal embolization (AVDE) complicates 6 to 18% of ST elevation myocardial infarction (STEMI) treated with PCI, and is associated with poor clinical outcomes. Culprit lesion characteristics have been proved to be the main predictive factor of AVDE. But data regarding clinical characteristics predicting AVDE are lacking. We aimed to identify predictors of AVDE complicating PCI in STEMI management. 769 consecutive patients admitted for STEMI who underwent PCI were included. Clinical, angiographic and therapeutics characteristics were assessed for each patien. AVDE was defined as an abrupt vessel closure occurring at any point during the PCI procedure and that was not present at baseline. Thrombectomy was used only when thrombolysis in myocardial infarction flow was≤2. AVDE occurred in 112 (14.5%) patients. Patients with AVDE were older (67±14 vs. 63±14; with p=0.010), less likely to be men (59 vs. 74%; with p=0.002), have more frequently an artery diameter>3mm (36 vs. 28%: with p=0.046), a right coronary artery culprit lesion site (59 vs. 37%; with p60 (OR[95% CI]: 1.69 (1.09-2.64); p=0.020), female gender (OR[95% CI]:1.71(1.09-2.70); p=0.020), thrombectomy (OR[95% CI]:1.67(1.10-2.53); p=0.016) and the right coronary artery culprit lesion site (OR[95% CI]:2.52(2.1.66-3.81); p60 year-old), female gender, thrombectomy and the right coronary artery culprit lesion site are the most powerful predictive factors of AVDE.

https://doi.org/10.1016/s1878-6480(16)30009-x