Frequency and predictors of thrombus inside the guiding catheter during interventional procedures: an optical coherence tomography study

Optical coherence tomography (OCT) is able to identify thrombus. We detect the frequency of thrombus inside the guiding catheter by OCT and its relationship with clinical and procedural factors. We screened 77 patients who underwent OCT pullbacks. Only patients with visible guiding catheter were finally included (35) and divided into thrombus (21) or no-thrombus group (14). Patients within thrombus group were mostly males (100 vs. 71 %, p = 0.05), with acute coronary syndrome (76 vs. 36 %, p = 0.02) and received more frequently percutaneous coronary intervention (86 vs. 43 %, p = 0.01) as compared to other group. A second dose of heparin was more frequently administered in thrombus than in other group (86 vs. 50 %, p = 0.01). Time between first heparin administration and OCT pullback (41[28–57] vs. 20 min [10–32], p = 0.001), time elapsed from second heparin administration and OCT pullback (29 [19–48] vs. 16 min [12–22], p = 0.002) and total procedural time (47 [36–69] vs. 31 min [26–39], p = 0.005) were longer in thrombus compared to other group. At multivariate analysis, total procedural time and time between first heparin administration and OCT pullback were only predictors of intra-catheter thrombus (HR 0.6 [0.3–0.9], p = 0.03 and HR 1.9 [1.1–3.2], p = 0.02, respectively). Thrombus inside guiding catheter may be a frequent finding in long interventional procedure. Future studies are warranted to determine its clinical impact

Sex-related impact on clinical outcome of everolimus-eluting versus bare-metal stents in ST-segment myocardial infarction. insights from the EXAMINATION trial

Introduction and objectives The use of second-generation drug-eluting stents compared with bare-metal stents in patients with ST-segment elevation myocardial infarction reduces the rate of major adverse cardiac events. We aimed to evaluate the impact of sex on the performance of everolimus-eluting stents vs bare-metal stents in ST-segment elevation myocardial infarction at 2-year follow-up. Methods This is a sub-study of the EXAMINATION trial that randomi