Document Detail

Thrombus aspiration without additional ballooning or stenting to treat selected patients with ST-elevation myocardial infarction.
MedLine Citation:
PMID:  20944189     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The use of thrombus aspiration during percutaneous coronary intervention (PCI) is recommended in patients with ST-elevation myocardial infarction (STEMI) undergoing mechanical revascularization. When thrombus aspiration is adopted, the standard technique includes, after mechanical thrombus extraction, angioplasty and/or stent implantation to eliminate residual stenosis. To date, no data are available concerning the use of thrombectomy alone without additional ballooning or stenting.
METHODS AND RESULTS: We report the angiographic and clinical outcome of a series of selected STEMI patients undergoing mechanical reperfusion by thrombus aspiration without additional ballooning or stenting. Four patients out of 316 consecutive STEMI patients were managed by thrombus aspiration alone (1.3%). All patients had angiographic documentation of an occlusive large intracoronary thrombus in the infarct-related artery before intervention and complete restoration of coronary flow in the absence of critical coronary stenosis after thrombus aspiration. Three of these patients had a clinical contraindication to dual antiplatelet therapy, thus suggesting that to avoid stent implantation would be advisable. Angiographic reevaluation was performed before discharge in 3 patients confirming persistent patency of the infarct-related artery (in 1 case the residual stenosis was judged to require intravascular ultrasound evaluation and subsequent elective PCI with stent implantation). The thirty-day clinical course was uneventful in all patients.
CONCLUSIONS: In selected patients with STEMI undergoing mechanical reperfusion, thrombus aspiration without additional ballooning or stenting may be successfully performed. Further studies are needed to assess the clinical relevance of this novel approach.
Giovanni Paolo Talarico; Francesco Burzotta; Carlo Trani; Italo Porto; Antonio Maria Leone; Giampaolo Niccoli; Valentina Coluccia; Giovanni Schiavoni; Filippo Crea
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  22     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-14     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  489-92     Citation Subset:  IM    
Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
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MeSH Terms
Aged, 80 and over
Angioplasty, Balloon, Coronary*
Coronary Angiography
Coronary Thrombosis / therapy
Middle Aged
Myocardial Infarction / diagnosis,  radiography,  therapy*
Myocardial Reperfusion
Thrombectomy* / methods
Comment In:
J Invasive Cardiol. 2010 Oct;22(10):493   [PMID:  20944190 ]

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