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Randomized Trial of Primary PCI with or without Routine Manual Thrombectomy

by Avezum, Alvaro , Rao, Sunil V , Džavík, Vladimír , Pancholy, Samir , ten Berg, Jurriën M , Steg, Philippe Gabriel , Cantor, Warren J , Bertrand, Olivier F , Meeks, Brandi , Niemelä, Kari , Yusuf, Salim , Kedev, Sasko , Rokoss, Michael J , Lavi, Shahar , Thabane, Lehana , Welsh, Robert C , Stankovic, Goran , Cheema, Asim N , Bernat, Ivo , Overgaard, Christopher B , Chowdhary, Saqib , Gao, Peggy , Cairns, John A , Widimsky, Petr , Naber, Christoph K , Moreno, Raul , Gershlick, Anthony , Bhindi, Ravinay , Xu, Yawei , Natarajan, Madhu K , Shestakovska, Olga , Pogue, Janice , Jolly, Sanjit S

in Aged / Bailouts / Blood clots / Cardiovascular diseases / Cardiovascular Diseases - mortality / Cardiovascular Diseases - prevention & control / Catheters / Cerebral infarction / Clinical trials / Combined Modality Therapy - adverse effects / Coronary Thrombosis - complications / Coronary Thrombosis - therapy / Coronary vessels / Death / Electrocardiography / Embolization / Evidence-based medicine / Female / Funding / Heart attacks / Heart diseases / Heart failure / Heart Failure - etiology / Heart surgery / Humans / Implants / Kaplan-Meier Estimate / Male / Medical research / Microvasculature / Microvessels / Middle Aged / Mortality / Myocardial infarction / Myocardial Infarction - complications / Myocardial Infarction - therapy / Percutaneous Coronary Intervention - adverse effects / Perfusion / Stroke / Stroke - etiology / Thrombectomy - adverse effects / Thrombosis

2015

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Randomized Trial of Primary PCI with or without Routine Manual Thrombectomy

2015

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2015

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Journal Article

Randomized Trial of Primary PCI with or without Routine Manual Thrombectomy

Avezum, Alvaro,

Rao, Sunil V,

Džavík, Vladimír,

Pancholy, Samir,

ten Berg, Jurriën M,

Steg, Philippe Gabriel,

Cantor, Warren J,

Bertrand, Olivier F,

Meeks, Brandi,

Niemelä, Kari,

Yusuf, Salim,

Kedev, Sasko,

Rokoss, Michael J,

Lavi, Shahar,

Thabane, Lehana,

Welsh, Robert C,

Stankovic, Goran,

Cheema, Asim N,

Bernat, Ivo,

Overgaard, Christopher B,

Chowdhary, Saqib,

Gao, Peggy,

Cairns, John A,

Widimsky, Petr,

Naber, Christoph K,

Moreno, Raul,

Gershlick, Anthony,

Bhindi, Ravinay,

Xu, Yawei,

Natarajan, Madhu K,

Shestakovska, Olga,

Pogue, Janice,

Jolly, Sanjit S

2015

Overview

Patients with STEMI were assigned to primary PCI with or without thrombectomy. At 180 days, there was no significant between-group difference in the primary outcome of death or cardiovascular events. Patients in the thrombectomy group had a higher rate of stroke at 30 days. Primary percutaneous coronary intervention (PCI), when available, is the most effective method of achieving reperfusion in patients with ST-segment elevation myocardial infarction (STEMI). 1 However, a major limitation of primary PCI is the possibility of distal embolization of thrombus and failure to restore flow at the microvascular level. Measures of microvascular tissue reperfusion, such as the degree of ST-segment resolution or angiographic myocardial blush grade, have been shown to predict the rate of death after primary PCI. 2 , 3 Removal of the thrombus by manual thrombectomy before stent deployment has the potential of reducing distal embolization and improving microvascular perfusion. Small, randomized . . .

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Publisher

Massachusetts Medical Society

Subject

Aged

/ Bailouts

/ Blood clots

/ Cardiovascular diseases

/ Cardiovascular Diseases - mortality

/ Cardiovascular Diseases - prevention & control

/ Catheters