Acute thrombotic-ischemic coronary syndromes: The usefulness of TEC

Transluminal extraction catheter (TEC) is a percutaneous device that perfor ms simultaneous thrombus aspiration and plaque excision. Clinical indicatio ns for its application are acute myocardial infarction, unstable angina, an d stable angina caused by atherosclerotic, thrombotic lesions located withi n native coronary arteries and degenerated saphenous vein grafts. The devic e is useful in management of ischemic patients with contraindications to ei ther pharmacologic thrombolytics or platelet GPIIb/IIIa receptor inhibitors , and can also effectively be used in combination with these agents. A succ essful TEC procedure requires careful patient selection, strict adherence t o recommended indications, optimal equipment selection, familiarity with me chanical components of the device, full understanding of safe and efficacio us techniques for deployment and activation, as well as recognition of uniq ue associated angiographic manifestations such as the "empty-pouch phenomen on." As with other debulking devices, the incidence of restenosis post-TEC appears to be directly related to acute luminal gain at the time of procedu re and therefore requires the need for adjunct stenting, This communication describes and illustrates various clinical, technical, and angiographic as pects of TEC procedure in patients with acute ischemic-thrombotic coronary syndromes. Cathet. Cardiovasc. Intervent, 48:406-424 1999. (C) 1999 Wiley-L iss, Inc.