ROLE OF ASPIRATION THROMBECTOMY IN PRIMARY PCI FOR STEMI - MYTH OR REALITY?

Abstract

Objective: The objective of the study was to determine the outcome of thrombus aspiration in Primary coronary
intervention (PCI) for ST elevation myocardial infarction (STEMI).
Design: Case Series
Place and Duration of Study: The study was carried out in Armed Forces Institute of Cardiology – National
Institute of Heart Diseases (AFIC-NIHD) over a period of twelve months from January 2013 to December 2013.
Patients and Methods: Data of 30 patients who underwent aspiration thrombectomy during primary PCI for
STEMI by the transradial approach was collected. Inclusion criteria were chest pain suggestive of myocardial
ischemia lasting longer than 30 min accompanied by ST- segment elevation or new left bundle branch block on
the ECG within 12 h of symptom onset. Patients with previous CABG, cardiogenic shock or requiring TPM
placement were excluded from this study. A 6F sheath was placed inside the radial artery, and cardiac
catheterization was performed. Angiographic and electrocardiographic signs of myocardial reperfusion were
assessed. Study endpoints included TIMI III flow and ST-segment resolution at the end of the procedure.
Results: Mean age of the patients was 52 years (range 37-77 yrs) and 63% (n= 19) were males and 37% (n=11) were
females. The right radial artery was used in 90% of cases. Thrombus aspiration catheter used was 6 F
Thrombuster II (70%) and Hunter (30%).There was significant improvement in markers of myocardial reperfusion
with achievement of ST-segment resolution and TIM
Conclusion: Thrombus aspiration (TA) is applicable in the majority of patients undergoing primary PCI for