Abstract 13740: Efficacy of Thrombectomy in Patients Undergoing Primary Percutaneous Coronary Intervention for Acute ST Elevation Myocardial Infarction: An Optical Coherence Tomography Study
Background- Manual thrombus aspiration is a helpful adjunctive therapy of percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Previous studies have demonstrated that tissue protrusion within the stent is associated with clinical outcomes after PCI. We used optical coherence tomography (OCT) to evaluate the impact of thrombus aspiration prior to balloon or stent angioplasty on tissue protrusions after stenting in patients with STEMI.
Methods- A total of 101 patients with STEMI who underwent standard PCI (n=41) or thrombus-aspiration PCI (n=60) were examined in the present study. Mean duration between symptom onset and primary PCI was 5.7 ± 4.2 hours. OCT was performed after PCI to assess lesion morphology in the stented segment.
Results- Baseline patient characteristics and stent profiles were comparable between the thrombus-aspiration and the standard PCI group. After primary PCI, TIMI flow grade >2 was attained in 92% in the thrombus-aspiration group compared with 90% in the standard PCI group (P>0.9). OCT measurements at maximl tissue protrusion area site demonstrated similar stent area (8.1 ± 2.8 mm2 vs. 7.6 ± 2.7 mm2, p=0.7), significantly smaller tissue protrusion area (0.5 ± 1.0 mm2 vs. 1.8 ± 1.6 mm2, p=0.002) and significantly greater lumen area (7.6 ± 2.6 mm2 vs. 5.7 ± 2.7 mm2, p=0.004) in the thrombus-aspiration PCI group compared to the standard PCI group.
Conclusions- Thrombus aspiration prior to balloon or stent angioplasty in patients with STEMI prevents tissue protrusion after stening and preserves luminal area in the treated segment, and it therefore represents a useful adjunctive therapy in primary PCI.
- © 2011 by American Heart Association, Inc.