Manual thrombectomy efficiency in relationship to the area at risk in patients with myocardial infarction with TIMI 0-1 coronary flow: Insights from an all comers registry

• Type: Article in International Scientific Journal
• Date: 2017-10-15

Authors

André Luz (Author) ICBAS

Journal

The Journal is awaiting validation by the Administrative Services.

Title: CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS

Vol. 90

Pages: 531-539

ISSN: 1522-1946

Indexing

ISI Web of Knowledge - 3 Citations

Other information

Authenticus ID: P-00N-3ZQ

DOI: 10.1002/ccd.26959

Abstract (EN): ObjectivesTo review the effectiveness of manual thrombectomy (MT) in a series of patients with ST-elevation myocardial infarction (STEMI) exclusively presenting with TIMI 0-1 flow undergoing percutaneous coronary intervention (PCI), in accordance to the angiographically estimated area at risk (AAR). Second, to assess major in-hospital clinical events, emphasizing neurological outcomes. BackgroundThe routine utilization of MT in STEMI is not recommended. However, in recent trials, a significant proportion of patients had neither large thrombus burden nor a totally occluded coronary segment, neutralizing the expected benefits of MT. In addition, the efficiency of MT to remove thrombus has rarely been addressed. Finally, MT diminished distal embolization, which has been related to mortality. ResultsIn 850 consecutive STEMI-patients, MT was utilized in 525 (62%) and it was considered efficient (TIMI 2-3 flow after MT) in 445 (85%). We found a significant interaction between the AAR and the effectiveness of MT to reduce infarct size (P-interaction=0.014). In patients having AAR28% (n=184), efficient MT conferred lesser infarct size compared to inefficient MT (Ln-transformed peak CK): 7.870.86 versus 8.36 +/- 0.41 IU/L, P=0.005, with no impact for AAR <28%. Clinical outcomes including stroke between MT and PCI-only groups were not different. ConclusionIn comparison with the group where MT was inefficient, efficient MT may modestly reduce final infarct size without a significant clinical benefit. In comparison with PCI-only, no difference was found regarding stroke. (c) 2017 Wiley Periodicals, Inc.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9