Abstract 2461: The Improved Outcome with AngioJet™ Thrombectomy Catheter During Primary Stenting in Acute Myocardial Infarction Patients with High-Grade Thrombus
Background - Primary stenting during acute myocardial infarction (AMI) with large intracoro-nary thrombus is often complicated by slow-flow/no-reflow due to distal embolization of intracoronary thrombus. The AngioJet thrombectomy catheter has been utilized in this setting in order to limit distal embolization and improve epicardial and microvascular flow. The utility of AngioJet thrombectomy during primary stenting in AMI with high-grade thrombus (≥ grade 3, as per TIMI classification) is not known.
Methods - We analyzed 176 consecutive AMI patients with thrombus grade ≥3 who underwent primary stenting with AngioJet (n = 94) and without AngioJet (n = 82) for the epicardial and microvascular flow, and correlated with 30-day MACE and 1-year survival. Baseline characteristics and in-hospital events were obtained from interventional database. Two independent operators analyzed pre- and post-procedure TIMI flow rates, corrected TIMI frame count (cTFC) and tissue myocardial perfusion grade (TMPG).
Results - Baseline clinical and angiographic characteristics were comparable between the two groups (see Table⇓).
Conclusion - Use of AngioJet thrombectomy prior to stenting of AMI patients with high-grade thrombus improves epicardial and microvascular flow, with better short and long-term outcomes. Our findings are in contrast with the negative results of AngioJet use in the AiMI trial, perhaps due to the different exclusion criteria (in AiMI trial all pts were included, irrespective of the thrombus size, while this trial included only pts with a large thrombus size).