Thrombus aspiration in late presenters with ST‐elevation myocardial infarction: A single‐center randomized trial

Rezq, Ahmed; Saad, Marwan

doi:10.1111/joic.12527

Cited by 4 publications

(2 citation statements)

References 28 publications

(53 reference statements)

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“…6 9 In late-acute MI, the thrombus may become organized over time, making predilatation and aspiration difficult in achieving antegrade flow. 10 11 12 As demonstrated in this case, these complications may be difficult to overcome with the conventional approach. Stenting of an atherothrombotic lesion with demarcated borders can reduce many complications during primary coronary intervention.…”

Section: Discussionmentioning

confidence: 89%

Thrombus-Demarcated Stenting with Dual-Contrast Imaging: A Novel Approach for Late-ST-Segment Elevation Myocardial Infarction with Unsuccessful Predilatation

Oguz,

Akbulut,

Saylik

et al. 2024

Int J Angiol

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The success of revascularization in the total occluded coronary lesion with dense thrombus burden is important for the short- and long-term prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI). In these lesions, stenting without dispersing the thrombus can increase the success of revascularization without fatal complications. The aim of this case is to demonstrate the newly developed thrombus-demarcated stenting with dual-contrast imaging approach after unsuccessful predilatation in a late-inferior STEMI. In centers where optical coherence tomography is not available, this technique can be used as an alternative.

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Section: Discussionmentioning

confidence: 89%

Thrombus-Demarcated Stenting with Dual-Contrast Imaging: A Novel Approach for Late-ST-Segment Elevation Myocardial Infarction with Unsuccessful Predilatation

Oguz,

Akbulut,

Saylik

et al. 2024

Int J Angiol

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“…Ruben et al have reported that rheolytic thrombectomy was associated with a lower target vessel revascularization in patients with acute myocardial infarction complicated by cardiogenic shock 22 . Ahmed et al found that thrombus aspiration might be associated with improved reperfusion and myocardial salvage especially in STEMI patients presenting after 12 h from symptom onset 23 . Accordingly, further investigations on AngioJet rheolytic thrombectomy among patients with high risk is warranted.…”

Section: Discussionmentioning

confidence: 99%

AngioJet rheolytic thrombectomy in patients with thrombolysis in myocardial infarction thrombus grade 5: an observational study

Huang

Cao²,

Chen³

et al. 2022

Sci Rep

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The aim of this study was to evaluate the effectiveness and safety of AngioJet rheolytic thrombectomy among patients with high thrombus burden. Routine manual thrombus aspiration in patients with ST-segment elevation myocardial infarction (STEMI) does not improve clinical outcomes and was associated with an increased rate of stroke. However, the safety of mechanical thrombus aspiration is still unknown. This was a retrospective, single-center study involving 621 patients with Thrombolysis In Myocardial Infarction thrombus grade 5. The primary outcome was the composite of major adverse cardiovascular events (MACE) within 12 months. The safety outcome was stroke within 1-year. Propensity matching score was calculated due to the significant baseline differences between the AngioJet rhelytic thrombectomy group and the routine treatment group. AngioJet rheolytic thrombectomy was performed in 117 patients. After propensity-score matching, there was no significant difference both in the incidence of MACE (11.1% vs 17.9%, hazard ratio, 1.641; 95% confidence interval [CI] 0.822 to 3.277, p = 0.161) and the incidences of stroke (1.7% vs 2.6%, hazard ratio 1.522; 95% confidence interval [CI] 0.254 to 9.107, p = 0.646) between two groups at 1-year follow-up. In patients with Thrombolysis In Myocardial Infarction thrombus grade 5, AngioJet rheolytic thrombectomy did not improve clinical outcomes at 1 year. However, AngioJet rheolytic thrombectomy did not increase the risk of stroke in patients with high thrombus burden.

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Thrombus aspiration in patients with ST-segment elevation myocardial infarction: a literature review

Ryabov,

Samoilova,

Gombozhapova

et al. 2023

Cardiovasc Ther Prev

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Thrombus aspiration has not shown significant advantages over routine percutaneous coronary intervention in reducing the incidence of major adverse cardiovascular events (MACEs) in the general heterogeneous population of patients with ST-segment elevation myocardial infarction (STEMI). However, it is still practically used in cases of massive coronary artery thrombosis. This review presents the results of studies on thrombus aspiration in patients with STEMI with a focus on favorable outcomes. According to the literature data, thrombus aspiration proved to be effective in following groups of STEMI patients: 1) patients with hyperglycemia; 2) patients with high D-dimer levels; 3) elderly and frail patients. In order to assess the effectiveness of reperfusion, only angiographic characteristics are still used in routine practice, while multimodal imaging methods have not yet become widespread. Moreover, optimal and unified thrombus aspiration protocols have not yet been developed.

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Thrombus aspiration in late presenters with ST‐elevation myocardial infarction: A single‐center randomized trial

Abstract: TA might be associated with improved reperfusion and myocardial salvage especially in STEMI patients presenting after 12 h from symptom onset who are likely to have a heavy thrombus burden.

Cited by 4 publications

References 28 publications

Thrombus-Demarcated Stenting with Dual-Contrast Imaging: A Novel Approach for Late-ST-Segment Elevation Myocardial Infarction with Unsuccessful Predilatation

Thrombus-Demarcated Stenting with Dual-Contrast Imaging: A Novel Approach for Late-ST-Segment Elevation Myocardial Infarction with Unsuccessful Predilatation

AngioJet rheolytic thrombectomy in patients with thrombolysis in myocardial infarction thrombus grade 5: an observational study

Thrombus aspiration in patients with ST-segment elevation myocardial infarction: a literature review

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