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A First-in-Man Study of the Reitan Catheter Pump for Circulatory Support in Patients Undergoing High-Risk Percutaneous Coronary Intervention

Smith, Elliot J.; Reitan, Öyvind LU ; Keeble, Thomas; Dixon, Kerry and Rothman, Martin T. (2009) In Catheterization and Cardiovascular Interventions 73(7). p.859-865
Abstract
Objectives: To investigate the safety of a novel percutaneous circulatory support device during high-risk percutaneous coronary intervention (PCI). Background: The Reitan catheter pump (RCP) consists of a catheter-mounted pump-head with a foldable propeller and surrounding cage. Positioned in the descending aorta the pump creates a pressure gradient, reducing afterload and enhancing organ perfusion. Methods: Ten consecutive patients requiring circulatory support underwent PCI; mean age 71 +/- 9; LVEF 34% +/- 11%; jeopardy score 8 +/- 2.3. The RCP was inserted via the femoral artery. Hemostasis was achieved using Perclose (TM) sutures. PCI was performed via the radial artery. Outcomes included in-hospital death, MI, stroke, and vascular... (More)
Objectives: To investigate the safety of a novel percutaneous circulatory support device during high-risk percutaneous coronary intervention (PCI). Background: The Reitan catheter pump (RCP) consists of a catheter-mounted pump-head with a foldable propeller and surrounding cage. Positioned in the descending aorta the pump creates a pressure gradient, reducing afterload and enhancing organ perfusion. Methods: Ten consecutive patients requiring circulatory support underwent PCI; mean age 71 +/- 9; LVEF 34% +/- 11%; jeopardy score 8 +/- 2.3. The RCP was inserted via the femoral artery. Hemostasis was achieved using Perclose (TM) sutures. PCI was performed via the radial artery. Outcomes included in-hospital death, MI, stroke, and vascular injury. Hemoglobin (Hb), free plasma Hb (fHb), platelets, and creatinine (cre) were measured pre PCI and post RCP removal. Results: The pump was inserted and operated successfully in 9/10 cases (median 79 min). Propeller rotation at 10,444 +/- 1,424 rpm maintained an aortic gradient of 9.8 +/- 2 mm Hg. Although fHb increased, there was no significant hemolysis (4.7 +/- 2.4 mg/dI pre vs. 11.9 +/- 10.5 post, P = 0.04, reference 20 mg/dI). Platelets were unchanged (pre 257 +/- 74 x 10(9) vs. 245 +/- 63, P = NS). Renal function improved (cre pre 110 +/- 27 mu mol/l vs. 99 +/- 28, P = 0.004). The RCP was not used in one patient following femoral introducer sheath related aortic dissection. All PCI procedures were successful with no deaths or strokes, one MI, and no vascular complications following pump removal. Conclusions: The RCP can be used safely in high-risk PCI patients. This device may be an alternative to other percutaneous systems when substantial cardiac support is needed. (C) 2009 Wiley-Liss, Inc. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
hemodynamic support device, coronary angioplasty, balloon pump
in
Catheterization and Cardiovascular Interventions
volume
73
issue
7
pages
859 - 865
publisher
Wiley-Blackwell
external identifiers
  • wos:000266521000002
  • scopus:68249160657
ISSN
1522-1946
DOI
10.1002/ccd.21865
language
English
LU publication?
yes
id
eaf93fef-77b6-4c89-928e-a95cc8095718 (old id 1444033)
date added to LUP
2009-07-17 11:16:28
date last changed
2017-11-05 04:14:36
@article{eaf93fef-77b6-4c89-928e-a95cc8095718,
  abstract     = {Objectives: To investigate the safety of a novel percutaneous circulatory support device during high-risk percutaneous coronary intervention (PCI). Background: The Reitan catheter pump (RCP) consists of a catheter-mounted pump-head with a foldable propeller and surrounding cage. Positioned in the descending aorta the pump creates a pressure gradient, reducing afterload and enhancing organ perfusion. Methods: Ten consecutive patients requiring circulatory support underwent PCI; mean age 71 +/- 9; LVEF 34% +/- 11%; jeopardy score 8 +/- 2.3. The RCP was inserted via the femoral artery. Hemostasis was achieved using Perclose (TM) sutures. PCI was performed via the radial artery. Outcomes included in-hospital death, MI, stroke, and vascular injury. Hemoglobin (Hb), free plasma Hb (fHb), platelets, and creatinine (cre) were measured pre PCI and post RCP removal. Results: The pump was inserted and operated successfully in 9/10 cases (median 79 min). Propeller rotation at 10,444 +/- 1,424 rpm maintained an aortic gradient of 9.8 +/- 2 mm Hg. Although fHb increased, there was no significant hemolysis (4.7 +/- 2.4 mg/dI pre vs. 11.9 +/- 10.5 post, P = 0.04, reference 20 mg/dI). Platelets were unchanged (pre 257 +/- 74 x 10(9) vs. 245 +/- 63, P = NS). Renal function improved (cre pre 110 +/- 27 mu mol/l vs. 99 +/- 28, P = 0.004). The RCP was not used in one patient following femoral introducer sheath related aortic dissection. All PCI procedures were successful with no deaths or strokes, one MI, and no vascular complications following pump removal. Conclusions: The RCP can be used safely in high-risk PCI patients. This device may be an alternative to other percutaneous systems when substantial cardiac support is needed. (C) 2009 Wiley-Liss, Inc.},
  author       = {Smith, Elliot J. and Reitan, Öyvind and Keeble, Thomas and Dixon, Kerry and Rothman, Martin T.},
  issn         = {1522-1946},
  keyword      = {hemodynamic support device,coronary angioplasty,balloon pump},
  language     = {eng},
  number       = {7},
  pages        = {859--865},
  publisher    = {Wiley-Blackwell},
  series       = {Catheterization and Cardiovascular Interventions},
  title        = {A First-in-Man Study of the Reitan Catheter Pump for Circulatory Support in Patients Undergoing High-Risk Percutaneous Coronary Intervention},
  url          = {http://dx.doi.org/10.1002/ccd.21865},
  volume       = {73},
  year         = {2009},
}