Abstract 12491: Impact of Positive Thrombus Retrieval During Primary Percutaneous Coronary Intervention with Thrombectomy on Infarct Size and Microvascular Obstruction
Background: Thromboaspiration (TA) during primary percutaneous intervention (PPCI) is effective in opening the infarct-related artery in patients with ST-segment elevation myocardial infarction (STEMI), leading to better reperfusion and improved outcome. However, the effect of positive macroscopic efficiency of TA remains unknown. We aimed to evaluate the impact of positive thrombus retrieval during PPCI with manual TA on infarct size (IS), microvascular obstruction (MVO) and left ventricular (LV) remodeling as assessed by contrast-enhanced magnetic resonance imaging (CE-MRI) in a subset of patients with STEMI.
Methods: Inclusion criteria were patients aged <75 years, with STEMI referred for PPCI within 12 hours of onset of symptoms, infarct-related artery ≥2.5 mm in diameter, thrombus score ≥3 and no prior history of coronary disease. All patients underwent TA before stenting and were categorized according to positive or negative TA. Clinical and procedural characteristics of study population were recorded and CE-MRI was performed at 5 days and 6-months to evaluate IS, MVO and LV remodeling as assessed by LV volumes.
Results: 73 patients were enrolled, mean age 55±10 years; 39.7% in the positive TA group. Main results are presented in the table. Clinical and procedural characteristics (90-min total ischemic time, ST-segment resolution, post-procedural TIMI flow grade and post-stenting myocardial blush grade, and peak troponin) did not differ significantly between groups.
Conclusion: Positive thrombus retrieval during primary PPCI with manual TA in STEMI reduces IS at 5 day and 6 months, reduces MVO and improves LV remodeling.
- © 2011 by American Heart Association, Inc.