Efficacy of Thrombus Aspiration Adjunct to Primary Percutaneous Intervention in ST-elevation Myocardial Infarction Patients with Heavy Thrombus Burden

摘要

The efficacy of thrombus aspiration (TA) for various culprit lesions in ST-segment elevation myocardial infarction has not been sufficiently evaluated, this directed recent randomized clinical trials to question its clinical benefits. We aimed to assess the efficacy of TA based primary percutaneous coronary intervention (PCI) in STEMI subgroup with heavy thrombus burden (TB) and compare it with conventional PCI in different STEMI subgroups. A comparative prospective study conducted on 60 patients (age 22-82 years) with acute STEMI who underwent primary PCI at our hospital from January 2016 to January 2017. Study population were divided into two groups: 1) patients with heavy TB or absence of flow after passage of guidewire underwent TA before stent deployment (test group, 30 patients) and 2) patients underwent conventional PCI (comparative group, 30 patients). Median follow-up duration was 5 days. Statistically significant differences; regarding final angiographic flow assessed by thrombolysis in myocardial infarction (TIMI) flow were found between the two groups in (TIMI) 0 before patients on TIMI flow after (TIMI 3 after 75.9 vs. 58.8%, TIMI 2 after 24.1 vs. 17.6%; P=0.05). In Conclusions; It is preferable to use TA before stenting in patients with STEMI with TIMI 0 flow before intervention.