No Beneficial Effects of Coronary Thrombectomy on Left Ventricular Systolic and Diastolic Function in Patients with Acute S-T Elevation Myocardial Infarction: A Randomized Clinical Trial

Andersen, Niels Holmark; Karlsen, Finn Michael; Gerdes, Jens Christian; Kaltoft, Anne; Sloth, Erik; Thuesen, Leif; Bøtker, Hans Erik; Poulsen, Steen Hvitfeldt

doi:10.1016/j.echo.2006.11.012

Cited by 16 publications

(16 citation statements)

References 38 publications

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“…Recently published meta-analyses on manual thrombectomy 10,11 excluded trials that tested the Rescue aspiration device, [12][13][14][15] which may bias the results. Other trials have not been included 16 -18 in previous meta-analyses.…”

Section: Editorial See P 1 Clinical Perspective On P 16mentioning

confidence: 99%

“…These analyses excluded trials [12][13][14][15] that tested the Rescue catheter (Boston Scientific) and thus the results may be misleading. We included these trials because we followed the device classification (aspiration versus mechanical thrombectomy catheters) proposed by Bavry et al 9 Given that the reduction in no reflow and distal embolization was observed regardless of the mechanism of thrombectomy, we believe that the lack of mortality benefit with nonaspiration devices 9,11 cannot be explained by worse angiographic outcomes.…”

Section: Mongeon Et Al Thrombectomy In Acute MI 11mentioning

confidence: 99%

“…13,24,32,33,35 Patients in shock or those requiring intra-aortic balloon counterpulsation or mechanical ventilation were excluded from 11 trials, 13,15,16,18,20,24,26,29,31,34,35 and patients with previous coronary artery bypass were excluded from 9 trials. 12,14,16,18,20,24,28,34,35 Only 2 RCTs specifically excluded patients with a left ventricular ejection fraction Ͻ30%. 26,29 Six trials reported crossovers from the control to the thrombectomy group (range, 3 to 18 patients).…”

Section: Differences In Inclusion and Exclusion Criteria In Selected mentioning

confidence: 99%

“…To test whether aspiration devices lead to better outcomes compared with standard PCI, we repeated the meta-analysis including only trials that used aspiration. [12][13][14][15][16][17][18][19][20]23,27,28,30,34,35,37 …”

Section: Thrombectomy Devicesmentioning

confidence: 99%

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Adjunctive Thrombectomy for Acute Myocardial Infarction

Mongeon

Bélisle

Joseph

et al. 2010

Circ: Cardiovascular Interventions

102

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Section: Editorial See P 1 Clinical Perspective On P 16mentioning

confidence: 99%

Section: Mongeon Et Al Thrombectomy In Acute MI 11mentioning

confidence: 99%

Section: Differences In Inclusion and Exclusion Criteria In Selected mentioning

confidence: 99%

Section: Thrombectomy Devicesmentioning

confidence: 99%

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Adjunctive Thrombectomy for Acute Myocardial Infarction

Mongeon

Bélisle

Joseph

et al. 2010

Circ: Cardiovascular Interventions

102

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“…An angiographically visible thrombus was required in 6 trials ( Table 2 and 3) 4,14, [34][35][36][37] . Patients in shock, requiring intra-aortic balloon counterpulsation or mechanical ventilation were excluded from 10 trials 4,10,11,13,34,[37][38][39][40][41] and patients with previous coronary artery bypass were excluded from 9 trials 4,12,13,33,34,[39][40][41][42] . Only 2 RCTs specifically excluded patients with a LVEF below 30% 10,38 .…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Trombectomia adjunta em intervenção percutânea primária para infarto agudo do miocárdio

Mongeon¹,

Coelho‐Filho²,

Coelho³

et al. 2011

Arq. Bras. Cardiol.

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Primary percutaneous coronary intervention (PCI) has become the favored reperfusion strategy in acute ST-segment elevation myocardial infarction. Lower post-PCI myocardial perfusion grade, no-reflow and even drug-eluting stent thrombosis have been related to the presence of intracoronary thrombus. Adjunctive thrombectomy refers to procedures and devices that remove thrombotic material from the infarctionrelated artery, in theory, before distal embolization can occur. There is substantial variability between randomized controlled trials of thrombectomy in primary PCI with regards to tested devices, procedural characteristics, adjuvant medical regimen and examined outcomes. As a general statement, improvements in myocardial perfusion endpoints do not translate into reductions in clinical outcomes. Yet, an increasing number of trials with a longer follow-up reported benefits arising late after the index myocardial infarction. Simple aspiration catheters may also produce better outcomes than devices that fragment the thrombus before aspirating debris. Clinical or angiographic variables which best predict benefits from the use of thrombectomy remain to be defined. The aim of this review is to provide perspective on the conclusions of available trials and meta-analysis of adjunctive thrombectomy in acute myocardial infarction. Targets for future studies are discussed.

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