Abstract 16207: Impact of Aspiration Thrombectomy on Myocardial Perfusion as Assessed by Index of Microcirculatory Resistance After Primary PCI in Acute ST-Elevation Myocardial Infarction
Background and objective: The use of routine aspiration thrombectomy in primary percutaneous coronary intervention (PCI) for acute ST-elevation myocardial infarction (STEMI) remains unclear. The purpose of this study was to evaluate the impact of aspiration thrombectomy on myocardial perfusion as assessed index of microcirculatory resistance (IMR).
Methods: The study population were 30 patients (male: 29) with STEMI within 6 hr of symptoms onset, who was successfully treated with primary PCI. All participants had TIMI flow 0/1 or definite angiographic thrombus (Grade 3/4). IMR was measured with a pressure sensor/thermistor-tipped guidewire following PCI. ST-segment resolution and myocardial blush grade were also recorded.
Results: Mean IMR was somewhat lower in the aspiration thrombectomy group (n = 20) than that of those without aspiration thrombectomy (n = 10, 21.7 ± 9.2 U vs. 65.8 ± 5.9 U, p=0.78). Myocardial blush grade >or=2 and ST-segment resolution occurred more frequently in the aspiration thrombectomy group (94.4% vs. 42.9%, p = 0.014; and 77.7% vs. 54.6%, p = 0.007) The IMR had significant negative correlation with myocardial blush grade (R = -0.67, p = 0.02)
Conclusion: Aspiration thrombectomy as adjunctive therapy in the treatment of STEMI appears to improve myocardial perfusion in case that the lesion is totally occluded or angiographic thrombus is present. On-site measurement of IMR following primary PCI may be an objective method to assess the adequacy of myocardial perfusion.
- © 2011 by American Heart Association, Inc.