Aspiration thrombectomy in patients undergoing primary angioplasty: Totality of data to 2013

Abstract

Our meta-analysis including all randomized controlled trials on aspiration thrombectomy to date demonstrates a significant reduction in adverse clinical outcomes including stent thrombosis compared with conventional PCI alone.

Aspiration Thrombectomy for Treatment of ST-segment Elevation Myocardial Infarction: a Meta-analysis of 26 Randomized Trials in 11 943 Patients

“…Kumbhani et al 26 showed a significant reduction of reinfarction and stent thrombosis during a weighted mean duration of followup of 2.7 months. Our results at 10.4 months showed no difference in the 2 endpoints between groups; however, after stratifying the extracted outcomes according to short-(30 days) or long-term…”

“…11,13,15,16,26 It has recently been suggested that even though a benefit was not observed at short-term follow-up, late mortality may be reduced by AT. 26 This prompted the question of whether the equipoise in early mortality was related to a lack of statistical precision or whether there was an actual mechanistic explanation for a potential reduction in late mortality. In a stratified analysis we found no formal interactions for the time point of evaluation of Figure 1.…”

Is Aspiration Thrombectomy Beneficial in Patients Undergoing Primary Percutaneous Coronary Intervention?

“…Prior randomized trials and meta-analyses had shown disparate results for the short-term benefits of aspiration thrombectomy [3][4][5][17][18][19][20][21] ; however, none of the studies was designed to address the potential synergistic effect of glycoprotein IIb/IIIa inhibitors on outcomes. In the INFUSE-AMI trial, patients were randomized in a 2×2 factorial design to intralesional abciximab at the site of the infarct lesion using a special infusion catheter versus no intracoronary abciximab.…”

“…3,[17][18][19][20][21] We communicated with select authors when further article clarification was necessary.…”

Randomized Trial of Primary PCI with or without Routine Manual Thrombectomy

“…9 Subsequently, the recent large Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia (TASTE) trial showed no reduction in mortality at 30 days or 1 year with routine thrombectomy. 10,11 Although an updated metaanalysis of thrombectomy that included the TASTE trial continued to suggest that a modest but clinically important benefit is possible, 12 the efficacy of this procedure remains uncertain.…”