Safety and efficacy of the AngioJet in patients with acute myocardial infarction: Results from the Florence Appraisal Study of Rheolytic Thrombectomy (FAST)

Massimo Margheri, Massimiliano Falai, Guido Vittori, Giuseppe G L Biondi Zoccai, Tania Chechi, Ilaria Ricceri, Elena Falchetti, Marco Comeglio, Cristina Giglioli, Serafina Valente, Gian Franco Gensini

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Abstract

OBJECTIVES: To assess the safety and efficacy of the AngioJet® coronary device, given the uncertain risk-benefit balance of rheolytic thrombectomy in patients with acute myocardial infarction (AMI). BACKGROUND: Current risk of inadequate myocardial perfusion for thrombus embolization in primary coronary interventions is not negligible. The AngioJet thrombectomy device showed promising results in terms of safety and efficacy, but failed to confirm them in a large, multicenter, randomized trial, and the risk-benefit balance is still uncertain. METHODS: The AngioJet device was employed in 116 consecutive patients with AMI and angiographic evidence of extensive thrombosis in a vessel with a reference diameter > 2.5 mm. Stents and glycoprotein IIb/IIIa inhibitors were liberally used. Epicardial and myocardial reperfusion angiographic parameters, and in-hospital major adverse cardiac events (MACE, i.e., cardiac death, myocardial infarction, target vessel revascularization) were assessed. RESULTS: The AngioJet was successfully used in all patients. Angiographic analysis showed that the AngioJet significantly improved epicardial coronary flow (p <0.01), frame count (p <0.01) and myocardial blush (p <0.01), while stenting yielded significant improvements only in diameter stenosis, minimum lesion diameter and correlated vessel parameters (p <0.01). In-hospital MACE were uncommon [9 (8%)], despite the patients' characteristics. When compared to an AMI population with similar thrombus burden but not undergoing thrombectomy, our AngioJet population showed significant improvement of reperfusion parameters. Moreover, there was greater AngioJet benefit in the high versus moderate thrombus burden subset; laboratory and operator experience also correlated significantly with final angiographic results. CONCLUSIONS: Our study supports the favorable risk-benefit profile of AngioJet device use in selected patients with AMI when used in experienced laboratories and by trained operators.

Original languageEnglish
Pages (from-to)481-486
Number of pages6
JournalJournal of Invasive Cardiology
Volume18
Issue number10
Publication statusPublished - Oct 2006

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Margheri, M., Falai, M., Vittori, G., Zoccai, G. G. L. B., Chechi, T., Ricceri, I., Falchetti, E., Comeglio, M., Giglioli, C., Valente, S., & Gensini, G. F. (2006). Safety and efficacy of the AngioJet in patients with acute myocardial infarction: Results from the Florence Appraisal Study of Rheolytic Thrombectomy (FAST). Journal of Invasive Cardiology, 18(10), 481-486.