Thrombus aspiration for reperfusion in myocardial infarction: Predictors and clinical impact of ineffectiveness

Luz, André; Rodrigues, Patrícia; Sousa, Maria João; Silveira, Inês; Anjo, Diana; Brochado, Bruno; Santos, Mário; Silveira, João; Carvalho, Henrique; Torres, Severo

doi:10.1016/j.repce.2014.05.007

Cited by 4 publications

(7 citation statements)

References 45 publications

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“…The main focus of later trials was to compare MT against PCI‐only with a lesser emphasis on its effectiveness and its interaction to the AAR. In a series from our institution, it was considered inefficient (inability to reach the lesion or to have a TIMI ≥ 2 after MT utilization prior to any other device) in 12.5% of cases and it was correlated to a significant higher rate of final no‐reflow phenomenon . In that series, both TIT and the Syntax score were found to be the major determinants of thrombectomy ineffectiveness, probably because thrombus may become more organized as time goes by, and therefore less likely to be removed and more likely to embolize to the microcirculation.…”

Section: Discussionmentioning

confidence: 89%

Manual thrombectomy efficiency in relationship to the area at risk in patients with myocardial infarction with TIMI 0‐1 coronary flow: Insights from an all comers registry

Luz

Silveira

Brochado

et al. 2017

Cathet Cardio Intervent

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Section: Discussionmentioning

confidence: 89%

Manual thrombectomy efficiency in relationship to the area at risk in patients with myocardial infarction with TIMI 0‐1 coronary flow: Insights from an all comers registry

Luz

Silveira

Brochado

et al. 2017

Cathet Cardio Intervent

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“…While the early increase is understandable, the extremely late increase (90-180 days) lacks a reasonable explanation and might be the result of chance. [8][9][10][11][12][13][14] In general, it is asserted that manual operations have a lower mortality rate than mechanical procedures, and that the therapy of patients with severe thrombus burdens should include both mechanical techniques and measures of myocardial perfusion. [19] There was no significant difference in one-month mortality between conventional PCI and PCI with thrombectomy, according to a recent meta-analysis by Tamhane et al, but manual devices enhanced myocardial perfusion parameters.…”

Section: Myocardial Infarctionmentioning

confidence: 99%

“…There is a theory that thrombus aspiration is advantageous for patients who appear early since observational analyses have revealed that it is less helpful for individuals with prolonged ischemia durations. [10] Others claim that patients with prolonged ischemia periods have structured thrombi, necessitating and benefiting more from thrombus aspiration. This topic was ready to be answered by the TOTAL (Thrombectomy with PCI versus PCI Alone in Patients with STEMI) experiment, which randomly assigned 10 732 STEMI patients to receive either upfront thrombus aspiration with PCI or PCI alone.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Patients who Received Bailout Thrombectomy for Primary Percutaneous Coronary Intervention

Osama¹,

Mansoor²,

Shah³

et al. 2023

PJMHS

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Objective: The purpose of this study was to compare outcomes among patients undergoing primary percutaneous coronary intervention with and without bailout thrombectomy. Study Design: Observational/ cross sectional study. Place and Duration: This observational/cross sectional study was conducted at Interventional Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan in the period from March,2022 to August, 2022. Methods: Total 140 patients of both gender had ST elevation myocardial infarction were presented for primary percutaneous coronary intervention. Patients were included after getting informed written consent for detailed demographics such as gender, age, comorbidities and history of CAD. We divided patients into two groups. Group I received only PPCI in 70 cases and 70 cases of group II received only PPCI with bailout thrombectomy. After PPCI comma results of both groups were compared. To analyzation of data, we use SPSS 18.0. Results: Among all presented cases, 80 (57.1%) were male patients and 60 (42.9%) were females. The patients mean age in group I was 53.17±11.62 years and in group II mean age was 55.9±10.94 years. Diabetes mellitus was the most common comorbidity found among both groups 35(50%) in group I and 27(38.6%) in group II followed by hypertension 21(30%) in group I and 24(34.3%) in group II. Family history of coronary artery disease (CAD) in group I was 19(27.1%) and in group II was 23(32.9%).There was no significance difference found in both groups in terms of mortality. There was significant higher number of renal impairment, stroke, heart failure, excess bleeding and renal infarction in group II as compared to group I with p value<0.05. Hospital stay was also higher in group II as compared to group I with p value<0.04. Conclusion: It is determined that patients who underwent bailout thrombectomy for percutaneous coronary intervention (PCI) had a significant risk of comorbidities. Between the two groups, there was no discernible variation in mortality. Those who underwent bailout thrombectomy, however, had higher rates of post-procedure stroke and renal impairment. Keywords, Bailout thrombectomy, Outcomes, ST-segment elevated myocardial infarction, PPCI.

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“…Observational analyses have found manual thrombus aspiration to be less effective for patients with longer ischemic times, so there is a hypothesis that thrombus aspiration is beneficial for patients who present early. 5 Others have argued that patients with longer ischemic times have an organized thrombus and thus have greater need for and benefit from thrombus aspiration. The TOTAL (Thrombectomy With PCI vs PCI Alone in Patients With STEMI) trial randomized 10 732 patients with STEMI to undergo either upfront thrombus aspiration with PCI or PCI alone and so was poised to answer this question.…”

Section: Introductionmentioning

confidence: 99%

“…Ischemic time may be associated with the amount of myocardial recovery after primary percutaneous coronary intervention (PCI). Observational analyses have found manual thrombus aspiration to be less effective for patients with longer ischemic times, so there is a hypothesis that thrombus aspiration is beneficial for patients who present early . Others have argued that patients with longer ischemic times have an organized thrombus and thus have greater need for and benefit from thrombus aspiration.…”

Section: Introductionmentioning

confidence: 99%

Association of Thrombus Aspiration With Time and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction

et al. 2021

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Key Points Question Is thrombus aspiration beneficial for patients who present early with ST-segment elevation myocardial infarction (STEMI)? Findings In this post hoc analysis of a randomized clinical trial, thrombus aspiration was associated with a greater reduction in distal embolization in patients who presented early with STEMI; however, it was not associated with improved clinical outcomes irrespective of time. Total ischemic time and door-to-device time were also important factors associated with mortality among patients with STEMI. Meaning This analysis suggests that thrombus aspiration does not appear to be associated with a benefit irrespective of ischemic time among patients with STEMI.

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Thrombus aspiration for reperfusion in myocardial infarction: Predictors and clinical impact of ineffectiveness

Cited by 4 publications

References 45 publications

Manual thrombectomy efficiency in relationship to the area at risk in patients with myocardial infarction with TIMI 0‐1 coronary flow: Insights from an all comers registry

Manual thrombectomy efficiency in relationship to the area at risk in patients with myocardial infarction with TIMI 0‐1 coronary flow: Insights from an all comers registry

Outcomes of Patients who Received Bailout Thrombectomy for Primary Percutaneous Coronary Intervention

Association of Thrombus Aspiration With Time and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction

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