Thrombus Aspiration and Balloon Pumps – What's the Bottom Line? - Dr. Yousif Ahmad

↳ This is a section part of Moment: Online Cardiac Catheter Lab Courses - Part 3: Essential guide:The NSTEMI/STEMI Patient

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Summary

Yousif Ahmad discusses adjunctive treatments for ACS in the catheter laboratory such as thrombus aspiration and balloon pumps (IABP)

  • When and when not to use
  • Real benefits and justification for thrombus aspiration and IABP use following clinical trials results

Thrombus aspiration

  • Theoretical advantages of thrombus aspiration
    • Reduce Embolisation
    • Reduce thrombus burden
    • Reduce no-reflow
    • Visualise anatomy better
    • Facilitate direct stenting
    • Facilitate shorter stents
  • TOTAL - No mortality benefit.  But, numerically small, but significantly small increase in stroke with thrombus aspiration.
  • Class III recommendation in USA for routine use of aspiration.  This suggests that it is of no certain benefit, and maybe harmful.  

Intra-arterial balloon pump (IABP)

  • Theoretical benefits in cardiogenic shock
    • Decrease afterload
    • Increase diastolic coronary perfusion
    • Augment blood pressure
  • Previously considered class I indication for treatment of shock, now (2016) Class III indication.  
  • No evidence of benefit in randomised trials
  • No evidence of benefit in observational trials

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Target Audience

  • Interventional cardiology trainees
  • Cardiology trainees
  • General practitioners with specialist interest in cardiology
  • Clinical fellows
  • Physiologists
  • Cath lab staff
  • Aspiring cardiology trainees

The 'Simple Essential Guide to Catheter Laboratory Diagnostic, Procedure and Therapeutics' course is designed for all busy Cardiology trainees, Clinical Fellows, Interventional Fellows, aspiring cardiologists and consultants looking for a rapid and simple update in this expanding field.

Each module of the 4 modules is designed to cover topics that will be encountered by all cardiologists regardless of specialisation and are therefore designed to provide the definitive update in the management of patients with coronary artery and structural heart disease for the practicing clinical cardiologist regardless of sub-specialty. So, if you want to be more confident in the catheter lab - this is the course for you!

Learning Objectives

  • Diagnosis of NSTEMI/STEMI
  • Pre catheter laboratory planning (Drugs, patient selection etc.)
  • Evidence behind choosing the correct anti platelet agents
  • Familarise yourself with Emergencies 
  • Learn about different catheters for emergency patients
  • Watch live case practical demonstrations
  • Post PCI management (Drugs, rehab etc.)

Other Components in this Moment

Overview
Does this Patient Need an Angioplasty? - Dr. Chris Baker
Preparing Your Patient for Angioplasty – What Complications Should You Discuss and What is their Incidence? - Dr. Neil Ruparelia
Fail Safe Guide to Access Routes and Guide Catheters in Acutely Unwell Patients - Dr. Amarjit Sethi
Anti-platelet Therapy and Anticoagulants in ACS Patients – Which? When? Why? – What if I Need to Stop? - Dr. Sukh Nijjer
Recorded Live Case and Discussion - Dr. Justin Davies, Dr. Chris Baker and Dr. Sayan Sen
Thrombus Aspiration and Balloon Pumps – What's the Bottom Line? - Dr. Yousif Ahmad
How Should You Treat/Assess Non-culprit Disease? - Dr. Justin Davies
What Medication Should the Patient Have on Discharge and Why? - Dr. Ricardo Pertraco
Post PPCI complications – When to Take the Patient Back to the Lab - Dr. Sukh Nijjer
Multiple Choice Assessment
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