Thrombus Aspiration in Late-Presenting STEMI Patients

Routine thrombus aspiration, prior to percutaneous coronary intervention (PCI), did not reduce microvascular obstruction, according to the results of a study presented Oct. 13 at TCT 2015 and simultaneously published in JACC: Cardiovascular Interventions.

Steffen Desch, MD, et al., randomized 152 subacute ST-elevated myocardial infarction patients presenting late after symptom onset to primary PCI with or without manual thrombus aspiration. Researchers then evaluated the extent of microvascular obstruction in the patients using cardiac magnetic resonance imaging.

The results of the study showed that thrombectomy before PCI did not alter the extent of microvascular obstruction. Further, the authors note that there was no significant differences in infarct size, myocardial salvage, left ventricular ejection fraction or angiographic endpoints in the patients.

In response to the failure of thrombus aspiration, the authors state that “aspiration will remove thrombotic material in many patients, but manipulation with the catheter might also dislodge thrombotic material with subsequent embolization into the microcirculation.” They add that “these opposing effects might balance each other resulting in a neutral outcome.” 

Keywords: Transcatheter Cardiovascular Therapeutics, Cardiovascular Diseases, Myocardial Infarction, Thrombosis

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