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CASES OF PRIMARY PCI WITH THROMBUS BURDEN Tips and tricks on using an Export Advance Thrombus Aspiration Catheter Dr Abdul Raqib bin Abd Ghani MBBS(Mal), MRCP(UK) Cardiology Clinical Specialist Serdang Hospital, MALAYSIA Greetings from MALAYSIA! case • 59 years old Malay male • known case of diabetes mellitus • chest pain while sleeping, typical angina • pain score of 10 • huge left coronary fistula from the left main to the pulmonary artery • Aneurysmal huge RCA with distally occluded PLV and PDA, non atherosclerotic • clots ++aspirated with an Export Advance catheter Not stented • TIMI flow Commenced on GP IIb/IIIa inhibitor infusion and admitted to CCU • pass a wire through the thrombosed segment before deciding on thrombus aspiration • increased rate of direct stenting • reduced need for multiple stents • reduced need for postdilatation • be on the lookout and be prepared for bradycardia, hypotension • bring aspiration catheter tip as close as possible to thrombus and open stop valve • peck thrombus slowly from proximal to distal • come into the guiding catheter if plunger needs to be replaced • when removing the aspiration cathether from the guiding catheter maintain a negative pressure ▸ no outcome benefits at 180 days ▸ increase stroke rate (HR 2.06) at 30 days Thank you for your kind attention