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A feasibility and safety study of intracoronary hemodilution during primary coronary angioplasty in order to reduce reperfusion injury in myocardial infarction

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A feasibility and safety study of intracoronary hemodilution during primary coronary angioplasty in order to reduce reperfusion injury in myocardial infarction. / McGarvey, Michael; Patterson, Tiffany; Redwood, Simon Robert.

In: CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Vol. 91, No. 2, 01.02.2018, p. 234-241.

Research output: Contribution to journalArticle

Harvard

McGarvey, M, Patterson, T & Redwood, SR 2018, 'A feasibility and safety study of intracoronary hemodilution during primary coronary angioplasty in order to reduce reperfusion injury in myocardial infarction', CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, vol. 91, no. 2, pp. 234-241. https://doi.org/10.1002/ccd.27136

APA

McGarvey, M., Patterson, T., & Redwood, S. R. (2018). A feasibility and safety study of intracoronary hemodilution during primary coronary angioplasty in order to reduce reperfusion injury in myocardial infarction. CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 91(2), 234-241. https://doi.org/10.1002/ccd.27136

Vancouver

McGarvey M, Patterson T, Redwood SR. A feasibility and safety study of intracoronary hemodilution during primary coronary angioplasty in order to reduce reperfusion injury in myocardial infarction. CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS. 2018 Feb 1;91(2):234-241. https://doi.org/10.1002/ccd.27136

Author

McGarvey, Michael ; Patterson, Tiffany ; Redwood, Simon Robert. / A feasibility and safety study of intracoronary hemodilution during primary coronary angioplasty in order to reduce reperfusion injury in myocardial infarction. In: CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS. 2018 ; Vol. 91, No. 2. pp. 234-241.

Bibtex Download

@article{714781152f9a49c1b989763e378d5155,
title = "A feasibility and safety study of intracoronary hemodilution during primary coronary angioplasty in order to reduce reperfusion injury in myocardial infarction",
abstract = "ObjectivesWe designed a pilot study to evaluate safety and feasibility of an inexpensive and simple approach to intracoronary hemodilution during primary angioplasty (PPCI) to reduce reperfusion injury.IntroductionEarly revascularization in acute myocardial infarction decreases infarct size and improves outcomes. However, abrupt restoration of coronary flow results in myocardial reperfusion injury and increased final infarct size. Dilution of coronary blood during revascularization may help reduce this damage. If proved effective, such an approach would need to be simple and suitable for widespread adoption.MethodsTen patients presenting with STEMI underwent intracoronary dilution with room temperature Hartmann's solution delivered through the guiding catheter during primary angioplasty (PPCI). Infusion of perfusate began prior to crossing the occluded artery with the guidewire, continuing until 10 min after completion of the balloon and stenting procedure. Infusion was briefly interrupted for contrast injection and pressure monitoring. The outcome measures were safety, including intracoronary temperature reduction and volume of intracoronary perfusate infused, and technical feasibility.ResultsThere were no significant symptomatic, hemodynamic, ECG ST/T segment or rhythm changes observed during perfusate administration. The median (interquartile range) volume of perfusate administered was 550 mL (350–725 mL) and the median intracoronary temperature reduction observed was 3.4°Celsius. Myocardial salvage was 0.54 (0.43–0.65).ConclusionsTranscatheter intracoronary hemodilution with room temperature perfusate during PPCI is feasible and appears safe. Such a strategy is simple and inexpensive, with potential to be widely applied. Further mechanistic and subsequent outcome powered studies are required to evaluate whether this strategy can reduce reperfusion injury in STEMI.",
author = "Michael McGarvey and Tiffany Patterson and Redwood, {Simon Robert}",
year = "2018",
month = feb,
day = "1",
doi = "10.1002/ccd.27136",
language = "English",
volume = "91",
pages = "234--241",
journal = "CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS",
issn = "1522-1946",
publisher = "Wiley-Liss Inc.",
number = "2",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - A feasibility and safety study of intracoronary hemodilution during primary coronary angioplasty in order to reduce reperfusion injury in myocardial infarction

AU - McGarvey, Michael

AU - Patterson, Tiffany

AU - Redwood, Simon Robert

PY - 2018/2/1

Y1 - 2018/2/1

N2 - ObjectivesWe designed a pilot study to evaluate safety and feasibility of an inexpensive and simple approach to intracoronary hemodilution during primary angioplasty (PPCI) to reduce reperfusion injury.IntroductionEarly revascularization in acute myocardial infarction decreases infarct size and improves outcomes. However, abrupt restoration of coronary flow results in myocardial reperfusion injury and increased final infarct size. Dilution of coronary blood during revascularization may help reduce this damage. If proved effective, such an approach would need to be simple and suitable for widespread adoption.MethodsTen patients presenting with STEMI underwent intracoronary dilution with room temperature Hartmann's solution delivered through the guiding catheter during primary angioplasty (PPCI). Infusion of perfusate began prior to crossing the occluded artery with the guidewire, continuing until 10 min after completion of the balloon and stenting procedure. Infusion was briefly interrupted for contrast injection and pressure monitoring. The outcome measures were safety, including intracoronary temperature reduction and volume of intracoronary perfusate infused, and technical feasibility.ResultsThere were no significant symptomatic, hemodynamic, ECG ST/T segment or rhythm changes observed during perfusate administration. The median (interquartile range) volume of perfusate administered was 550 mL (350–725 mL) and the median intracoronary temperature reduction observed was 3.4°Celsius. Myocardial salvage was 0.54 (0.43–0.65).ConclusionsTranscatheter intracoronary hemodilution with room temperature perfusate during PPCI is feasible and appears safe. Such a strategy is simple and inexpensive, with potential to be widely applied. Further mechanistic and subsequent outcome powered studies are required to evaluate whether this strategy can reduce reperfusion injury in STEMI.

AB - ObjectivesWe designed a pilot study to evaluate safety and feasibility of an inexpensive and simple approach to intracoronary hemodilution during primary angioplasty (PPCI) to reduce reperfusion injury.IntroductionEarly revascularization in acute myocardial infarction decreases infarct size and improves outcomes. However, abrupt restoration of coronary flow results in myocardial reperfusion injury and increased final infarct size. Dilution of coronary blood during revascularization may help reduce this damage. If proved effective, such an approach would need to be simple and suitable for widespread adoption.MethodsTen patients presenting with STEMI underwent intracoronary dilution with room temperature Hartmann's solution delivered through the guiding catheter during primary angioplasty (PPCI). Infusion of perfusate began prior to crossing the occluded artery with the guidewire, continuing until 10 min after completion of the balloon and stenting procedure. Infusion was briefly interrupted for contrast injection and pressure monitoring. The outcome measures were safety, including intracoronary temperature reduction and volume of intracoronary perfusate infused, and technical feasibility.ResultsThere were no significant symptomatic, hemodynamic, ECG ST/T segment or rhythm changes observed during perfusate administration. The median (interquartile range) volume of perfusate administered was 550 mL (350–725 mL) and the median intracoronary temperature reduction observed was 3.4°Celsius. Myocardial salvage was 0.54 (0.43–0.65).ConclusionsTranscatheter intracoronary hemodilution with room temperature perfusate during PPCI is feasible and appears safe. Such a strategy is simple and inexpensive, with potential to be widely applied. Further mechanistic and subsequent outcome powered studies are required to evaluate whether this strategy can reduce reperfusion injury in STEMI.

U2 - 10.1002/ccd.27136

DO - 10.1002/ccd.27136

M3 - Article

VL - 91

SP - 234

EP - 241

JO - CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS

JF - CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS

SN - 1522-1946

IS - 2

ER -

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