Impact of thrombus aspiration on angiographic and clinical outcomes in patients with ST-elevation myocardial infarction

Autor: Onil Gleeton, Jonathan Beaudoin, Can Nguyen, Louis Roy, Guy Proulx, Philippe Lachance, Jean-Pierre Déry, Robert DeLarochellière, Josep Rodés-Cabau, Stéphane Rinfret, Olivier F. Bertrand, Eric Larose, Gérald Barbeau, Bernard Noël
Rok vydání: 2010
Předmět:
Male
medicine.medical_specialty
Catheters
Time Factors
medicine.medical_treatment
Myocardial Infarction
Kaplan-Meier Estimate
Suction
Coronary Angiography
Revascularization
Risk Assessment
Disease-Free Survival
Coronary thrombosis
Recurrence
Risk Factors
Coronary Circulation
Internal medicine
Angioplasty
medicine
Humans
cardiovascular diseases
Myocardial infarction
Angioplasty
Balloon
Coronary
Thrombus
Aged
Proportional Hazards Models
Retrospective Studies
Thrombectomy
Chi-Square Distribution
business.industry
Coronary Thrombosis
Patient Selection
Quebec
Percutaneous coronary intervention
Equipment Design
General Medicine
Middle Aged
medicine.disease
Stroke
Logistic Models
Treatment Outcome
surgical procedures
operative
Conventional PCI
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
TIMI
Zdroj: Cardiovascular Revascularization Medicine. 11:218-222
ISSN: 1553-8389
DOI: 10.1016/j.carrev.2009.05.005
Popis: Primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) may be limited by thrombus embolization. Export aspiration catheter (EAC) is a thrombectomy device which may enhance angiographic results, but its impact on clinical outcomes is unclear. This trial objective was to assess the impact of EAC on angiographic and clinical outcomes in patients with STEMI.All STEMI patients undergoing primary or rescue PCI in a tertiary care center were included. Patients were divided in two groups according to the use of the EAC. Patients were followed up prospectively for death, reinfarction, revascularization, or stroke. Thrombolysis In Myocardial Infarction (TIMI) flow in the culprit vessel was assessed before and after PCI.Included in the analysis were 535 patients. EAC was used in 165 patients before angioplasty (Group 1) and 370 patients underwent PCI without thrombus aspiration (Group 2). More patients in Group 1 had initial TIMI flow 0-1 compared to Group 2 (88% vs. 62%, P.001). Proportion of patients with a final TIMI flow 3 was the same in both groups (89.1% vs. 87.6% for Groups 1 and 2, respectively; P=.67). An analysis restricted to patients with initial TIMI flow 0-1 yielded similar results. No difference in clinical outcomes was observed between the two groups (P=.70).Selective use of the EAC based on the judgment of operators results in excellent angiographic and clinical results. Further clinical investigation is needed to definitely answer whether thromboaspiration needs to be performed in all STEMI patients undergoing primary PCI.
Databáze: OpenAIRE
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