Eric R. Bates

Paul A. Gurbel; Frank I. Navetta; Eric R. Bates; David W. Muller; Alan N. Tenaglia; Michael J. Miller; Brent Muhlstein; James B. Hermiller; Charles J. Davidson; Frank V. Aguirre; Glenn J. Beauman; Lisa G. Berdan; Jeffrey D. Leimberger; Edwin G. Bovill; Robert H Christenson; E. Magnus Ohman

Percutaneous coronary revascularization in patients with unstable angina and coronary thrombus carries a high complication rate. A new strategy to reduce thrombus burden before revascularization was tested in a multicenter prospective trial. Patients with unstable angina and coronary thrombus (n = 45) received alteplase through an infusion catheter at the proximal aspect of the target lesion and concomitant intracoronary heparin via a standard guiding catheter. Angiography was performed before and alter lesion-directed therapy and post-intervention. Systemic fibrinogen depletion and thrombin activation were not observed, while fibrinolysis was evident for > or = 4 hr after treatment. Target lesion stenosis did not change significantly after lesion-directed therapy, but thrombus score was reduced, particularly among patients who had large thrombi (mean 2.2 vs. 1.6, P = 0.02). Revascularization was successful in 89% of patients. Median final stenosis was 30% and mean final thrombus score was 0.4. Complications included recurrent ischemia (11%), MI (7%), abrupt closure (7%), severe bleeding (4%), and repeat emergency angioplasty (2%). Patients with overt thrombus appeared to derive the most angiographic benefit from lesion-directed alteplase plus intracoronary heparin. Later revascularization was highly successful. This strategy may be a useful adjunct to percutaneous revascularization for patients with unstable angina and frank intracoronary thrombus.

W. Keith Hoots; Yves Rosenberg; Matthew J. Price; David J. Schneider; Daniel I. Simon; Jeffrey I. Weitz; S Marlene; Jean-Sébastien Hulot; Kenneth G. Mann; Jessica L. Mega; Kiran Musunuru; J. Angiolillo; Eric R. Bates; David J. Cohen; Barry S. Coller; Bruce Furie; Valentin Fuster; Deepak L. Bhatt; Robert M. Califf; Alan D. Michelson; Marc S. Sabatine

Brahmajee K. Nallamothu; Rodney A. Hayward; Eric R. Bates

Henry H. Ting; Roxana Mehran; Issam Moussa; Debabrata Mukherjee; Robert A. Guyton; Steven M. Hollenberg; Umesh N. Khot; Richard A. Lange; Steven R. Bailey; John A. Bittl; Bojan Cercek; Charles E. Chambers; G Stephen; Glenn N. Levine; Eric R. Bates; James C. Blankenship

David O. Williams; A. Morrison; Joseph P. Ornato; David L. Pearle; Eric D. Peterson; Michael A. Sloan; Lee A. Green; Judith S. Hochman; Alice K. Jacobs; Harlan M. Krumholz; Elliott M. Antman; Steven R. Bailey; Eric R. Bates; James C. Blankenship; G. Kushner; Spencer B. King; L Jeffrey

D. Moussa; Brahmajee K. Nallamothu; Henry H. Ting; Steven M. Hollenberg; Umesh N. Khot; Richard A. Lange; Laura Mauri; Roxana Mehran; John A. Bittl; Charles E. Chambers; Stephen G. Ellis; Robert A. Guyton; Glenn N. Levine; Eric R. Bates; James C. Blankenship

D. Moussa; Brahmajee K. Nallamothu; Henry H. Ting; Steven M. Hollenberg; Umesh N. Khot; Richard A. Lange; Laura Mauri; Roxana Mehran; John A. Bittl; Charles E. Chambers; Stephen G. Ellis; Robert A. Guyton; Glenn N. Levine; Eric R. Bates; James C. Blankenship

Issam Moussa; Brahmajee K. Nallamothu; Umesh N. Khot; Richard Lange; Laura Mauri; Roxana Mehran; Bojan Cercek; Charles E. Chambers; Stephen G. Ellis; Robert A. Guyton; Glenn N. Levine; Eric R. Bates; James C. Blankenship; Steven R. Bailey

Dean Karavite; Eric R. Bates; David W. Muller; Steven W. Werns; Eva Kline Rogers; Mauro Moscucci; Stephen G. Ellis; David J. Malenka

Rajendra H. Mehta; Eric R. Bates