Abstract 2502: Role of Thrombectomy and Distal Protection Devices in Acute Myocardial Infarction. Is their Routine Use of Clinical Benefit? A Meta-Analysis
Background: Thromboembolic debris liberated during primary coronary intervention (PCI) might worsen clinical outcomes. Individual randomized control trials (RCT’s) on thrombectomy or distal protection devices have documented improvement in ST segment resolution or angiographic myocardial perfusion, but the clinical benefit of their routine use remains unclear.
Objective: To combine data from all RCT’s using these devices in conjunction with PCI. The primary end-point of this investigation was to assess their potential impact on death and reinfarction (reMI) at 30 days.
Methods: Data from nine RCT’s (EMERALD, Antoniucci, Napodano, X AMINE ST, REMEDIA, AIMI, PROMISE, DIPLOMAT, ASPARAGUS) were analyzed, including 2060 patients. Of them, 1035 were randomized to active treatment whilst the remaining 1025 were controls.
Results: Clinical outcomes are shown in the table⇓.
Conclusion: Routine use of thrombectomy/distal protection devices in patients undergoing primary PCI does not improve death or reinfarction at 30 days. Whether there is long-term clinical benefit can not be answered at the present time.