• Michał Ciszewski, Jerzy Pregowski, Anna Teresińska, Maciej Karcz, Łukasz Kalińczuk, Radosław Pracon, Adam Witkowski, and Witold Rużyłło.
• Institute of Cardiology, Warsaw, Poland. mciszewski@ikard.pl
• Catheter Cardiovasc Interv. 2011 Oct 1;78(4):523-31.

ObjectivesThe aim of the study was to assess if aspiration thrombectomy in high risk patients with STEMI and angiographic evidence of thrombus may improve myocardial salvage.BackgroundIt is unclear if thrombus aspiration before percutaneous intervention (PCI) improves myocardial salvage.MethodsThe trial was a prospective randomized study. The inclusion criteria were: first STEMI within 12 hr from symptoms onset, culprit lesion in left anterior descending or right coronary artery, culprit artery TIMI flow ≤ 2 and angiographic evidence of thrombus. The primary endpoint was myocardial salvage index (MSI) as assessed by (99m) Tc-sestamibi SPECT imaging.ResultsWe randomized 137 patients (98 male, mean age 64.1 ± 12.5 years) either to aspiration thrombectomy followed by standard PCI with stent implantation (n = 67) or to standard primary PCI (n = 70). Index perfusion defect was similar in both study groups: 34.2% ± 13.1% in thrombectomy group versus 37.1% ± 12.0% in primary PCI group (P = 0.2). MSI was larger in aspiration thrombectomy group than in control patients [25.4% (IQR 13.5-44) vs. 18.5% (IQR 7.7-30.3) respectively, P = 0.02]. The final infarct size was smaller in patients treated with aspiration thrombectomy (23.1% ± 13.3% vs. 28.9% ± 10.2% in the control group, P = 0.002).ConclusionsAspiration thrombectomy improves myocardial salvage in high risk STEMI patients with angiographic evidence of thrombus.Copyright © 2011 Wiley-Liss, Inc.

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