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

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

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