American Heart Journal
Volume 157, Issue 3 , Pages 583.e1-583.e7 , March 2009

Effect of thrombus aspiration on infarct size and left ventricular function in high-risk patients with acute myocardial infarction treated by percutaneous coronary intervention. Results of a prospective controlled pilot study

  • Janusz Lipiecki, MD, PhD, FESC, FSCAI

      Affiliations

    • Department of Cardiology, G. Montpied University Hospital, Clermont-Ferrand, France
    • Corresponding Author InformationReprint requests: Janusz Lipiecki, MD, Department of Cardiology, G. Montpied University Hospital, rue Montalembert, 63000 Clermont-Ferrand, France.
  • ,
  • Séverine Monzy, MD

      Affiliations

    • Department of Cardiology, G. Montpied University Hospital, Clermont-Ferrand, France
  • ,
  • Nicolas Durel, MD

      Affiliations

    • Department of Cardiology, G. Montpied University Hospital, Clermont-Ferrand, France
  • ,
  • Florent Cachin, MD

      Affiliations

    • Department of Nuclear Medicine, Jean Perrin Cancer Center, Clermont-Ferrand, France
  • ,
  • Pascal Chabrot, MD

      Affiliations

    • Department of Radiology, G. Montpied University Hospital, Clermont-Ferrand, France
  • ,
  • Aurelien Muliez, MSc

      Affiliations

    • Department of Statistics, G. Montpied University Hospital, Clermont-Ferrand, France
  • ,
  • Dominique Morand, MSc

      Affiliations

    • Department of Statistics, G. Montpied University Hospital, Clermont-Ferrand, France
  • ,
  • Jean Maublant, MD, PhD

      Affiliations

    • Department of Nuclear Medicine, Jean Perrin Cancer Center, Clermont-Ferrand, France
  • ,
  • Jean Ponsonnaille, MD

      Affiliations

    • Department of Cardiology, G. Montpied University Hospital, Clermont-Ferrand, France

Received 1 October 2008 ,Accepted 26 November 2008.

References 

  1. Stone GW, Grines CL, Cox DA, et al. Comparison of angioplasty with stenting, with and without abciximab, in acute myocardial infarction. N Engl J Med. 2002;346:957
  2. Yellon DM, Hausenloy DJ. Myocardial reperfusion injury. N Engl J Med. 2007;357:1121–1135
  3. Henriques JP, Zijstra F, Ottervanger JP, et al. Incidence and clinical significance of distal embolisation during primary angioplasty for acute myocardial infarction. Eur Heart J. 2002;23:1112–1117
  4. Napodano M, Pasquetto G, Sacca S, et al. Intracoronary thrombectomy improves myocardial reperfusion in patients undergoing direct angioplasty for acute myocardial infarction. J Am Coll Cardiol. 2003;42:1395–1402
  5. Antoniucci D, Valenti R, Migliorini A, et al. Comparison of rheolytic thrombectomy before direct infarct artery stenting versus direct stenting alone in patients undergoing percutaneous coronary intervention for acute myocardial infarction. Am J Cardiol. 2004;93:1033–1035
  6. Burzotta F, Trani C, Romagnoli E, et al. Manual thrombus-aspiration improves myocardial reperfusion. J Am Coll Cardiol. 2005;46:371–376
  7. Silva-Orego P, Colombo P, Bigi R, et al. Thrombus aspiration before primary angioplasty improves myocardial reperfusion in acute myocardial infarction. J Am Coll Cardiol. 2006;48:1552–1559
  8. Kaltoft A, Bottcher M, Nielsen SS, et al. Routine thrombectomy in percutaneous coronary intervention for acute ST-segment-elevation myocardial infarction. A randomized, controlled trial. Circulation. 2006;114:40–47
  9. Ali A, Cox D, Dib N, et al. Rheolytic thrombectomy with percutaneous coronary intervention for infarct size reduction in acute myocardial infarction. J Am Coll Cardiol. 2006;48:244–252
  10. De Luca L, Sardella G, Davidson CJ, et al. Impact of intracoronary aspiration thrombectomy during primary angioplasty on left ventricular remodeling in patients with anterior ST elevation myocardial infarction. Heart. 2006;92:951–957
  11. Svilaas T, Vlaar PJ, van der Horst IC, et al. Thrombus aspiration during primary coronary intervention. N Engl J Med. 2008;358:557–567
  12. Vlaar PJ, van der Horst IC, Diercks GFH, et al. Cardiac death and reinfarction after 1 year in the thrombus aspiration during percutaneous coronary intervention in acute myocardial infarction study (TAPAS): a 1-year follow-up study. Lancet. 2008;371:1915–1920
  13. Javaid A, Siddiqi N, Steinberg DH, et al. Adjunct thrombus aspiration reduces mortality in patients undergoing percutaneous coronary intervention for ST-elevation myocardial infarction with high-risk angiographic characteristics. Am J Cardiol. 2008;1001:452–456
  14. Gibbons RJ, Valeti US, Aaroz PA, et al. The quantification of infarct size. J Am Coll Cardiol. 2004;44:1533–1542
  15. Cerqueira MD, Weissman NJ, Dilsizian V, et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the cardiac imaging committee of the council on clinical cardiology of the American Heart Association. Circulation. 2002;105:539–542
  16. Rentrop KP, Thornton JC, Feit F, et al. Determinants and protective potential of coronary arterial collaterals as assessed by an angioplasty model. Am J Cardiol. 1988;61:677–684
  17. van't Hof AW, Liem A, Suryapranata H, et al. Angiographic assessment of myocardial reperfusion in patients treated with primary angioplasty for acute myocardial infarction: myocardial blush grade. Zwolle Myocardial Infarction Study Group. Circulation. 1998;97:2302–2306
  18. Schröder R, Dissmann R, Bruggemann T, et al. Extent of early ST elevation resolution: a simple but strong predictor of outcome in patients with acute myocardial infarction. J Am Coll Cardiol. 1994;24:384–391
  19. Hombach V, Grebe O, Merkle N, et al. Sequelae of acute myocardial infarction regarding cardiac structure and function and their prognostic significance as assessed by magnetic resonance imaging. Eur Heart J. 2005;26:549–557
  20. Kishi T, Yamada A, Okamatsu S, et al. Percutaneous coronary arterial thrombectomy for acute myocardial infarction reduces no-reflow phenomenon and protects against left ventricular remodeling related to the proximal left anterior descending and right coronary artery. Int Heart J. 2007;48:287–302
  21. Kondo H, Suzuki T, Fukutomi T, et al. Effects of percutaneous coronary arterial thrombectomy during acute myocardial infarction on left ventricular remodeling. Am J Cardiol. 2004;93:527–531
  22. Galiuto L, Garramone B, Burzotta F, et al. Thrombus aspiration reduces microvascular obstruction after primary coronary intervention. A myocardial contrast echocardiography substudy of the REMADIA trial. J Am Coll Cardiol. 2006;48:1355–1360
  23. Kunadian B, Dunning J, Vijayalakshmi , et al. Meta-analysis of randomized trials comparing anti-embolic devices with standard PCI for improving myocardial reperfusion in patients with acute myocardial infarction. Cathet Cardiovasc Interv. 2007;69:488–496
  24. Burzotta F, Testa L, Giannico F, et al. Adjunctive devices in primary or rescue PCI: a meta-analysis of randomized trials. Int J Cardiol. 2008;123:313–321
  25. De Luca G, Dudek D, Sardella G, et al. Adjunctive manual thrombectomy improves myocardial perfusion and mortality in patients undergoing percutaneous coronary intervention for ST-elevation myocardial infarction: a meta-analysis of randomized trials. Eur Heart J. 2008;29:3002–3010
  26. Antoniucci D, Valenti R, Migliorini A, et al. Direct infarct artery stenting without predilatation and no-reflow in patients with acute myocardial infarction. Am Heart J. 2001;142:684–690
  27. Sabatier R, Hamon M, Zhao QM, et al. Could direct stenting reduce no-reflow in acute coronary syndromes? A randomized pilot study. Am Heart J. 2002;143:1027–1032
  28. Staat P, Rioufool G, Piot C, et al. Postconditioning the human heart. Circulation. 2005;112:2143–2148
  29. v. Korn H, Ohlow M, Donev S, et al. Export aspiration system in patients with acute coronary syndrome and visible thrombus provides no substantial benefit. Cathet Cardiovasc Interv. 2007;70:35–42

 ClinicalTrials.gov identifier: NCT00456066.

PII: S0002-8703(08)01040-5

doi: 10.1016/j.ahj.2008.11.017

American Heart Journal
Volume 157, Issue 3 , Pages 583.e1-583.e7 , March 2009