Response by Jolly et al to Letters Regarding Article, “Thrombus Aspiration in ST-Segment-Elevation Myocardial Infarction: An Individual Patient Meta-Analysis: Thrombectomy Trialists Collaboration”
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Karamasis and colleagues describe their own registry of patients with ST-segment–elevation myocardial infarction undergoing thrombus aspiration in whom they performed serial ECGs and showed worsening in ST-segment elevation in 13.5% of cases after the first wire passage, in 19.7% of cases after thrombus aspiration, and in 12.5% of cases at the end of the procedure. Thus, >50% ST-segment resolution occurred in 15.2% after wire passage, in 21.8% after thrombus aspiration, and in 44.3% at the end of the procedure.1 However, without a control group for comparison, one should be cautious about the interpretation of these results. Thrombus aspiration devices may cause transient reductions in flow after thrombus aspiration, which may be related to disruption of culprit plaque or distal embolization.
Although we agree that thrombus aspiration can in some cases “effectively remove thrombus and …