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Detection of Acute Atrial Thrombus in a Porcine Model With Atrial Fibrillation With Tc 99m-Apcitide

DeHoyos, Maj Jose C. MD; Rubal, Bernard J. PhD; Bradley, Maj Yong C. MD

doi: 10.1097/01.rli.0000112901.01665.e1
Original Article

Rationale and Objectives: Technetium-99m apcitide (AcuTect) is a peptide with high affinity and specificity for glycoprotein IIb/IIIa receptors on platelets and is currently approved for the diagnosis of deep venous thrombosis. This study evaluates the use of Tc-99m apcitide for detecting intracardiac thrombus in an animal model with atrial fibrillation.

Methods: Thrombogenic material (0.23 ± 0.03 g) was implanted within the left atrium of 5 swine with induced atrial fibrillation. Scintigraphy was performed with a small field of view gamma camera (minimum of 400,000 counts) 1 hour after implantation at 10, 60, and 120 minutes after the injection of the Tc-99m apcitide. Animals were then euthanized and a postmortem examination performed to confirm thrombus formation.

Results: In all animals, thrombi and microthrombi were confirmed within the left atrial appendage. The average wet weight of the thrombus was 1.4 ± 0.2 g. Tc-99m apcitide detected left atrial thrombus in all animals.

Conclusions: This study suggests that AcuTect may prove useful for detecting intracardiac thrombus in future clinical studies in man.

From the Cardiology Service and the Department of Nuclear Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as reflecting the views of the Department of the Army or the Department of Defense.

Received June 15, 2003 and accepted for publication, after revision, December 1, 2003.

Reprints: MAJ Jose C. DeHoyos, MD, Brooke Army Medical Center 3851 Roger Brooke Drive, Bldg. 3600 Cardiology Service MCHE-MDC Fort Sam Houston, TX 78234-6200. E-mail:

© 2004 Lippincott Williams & Wilkins, Inc.