Thrombus Aspiration in STEMI

Current Treatment Options in Cardiovascular Medicine
Konstantinos MarmagkiolisKonstantinos Charitakis

Abstract

ST-segment elevation myocardial infarction (STEMI) remains an important cause of morbidity and mortality. In the USA, the development of an organized STEMI network has allowed STEMI patients greater access to primary PCI. The most important goal in the management of STEMI is timely reperfusion and establishment of normal coronary flow. However, periprocedural thrombus embolization, which can obstruct the distal microvasculature and impair tissue perfusion, is associated with unfavorable outcomes. Over the last years, aspiration thrombectomy has emerged as a novel technique to prevent distal coronary thromboembolism during primary PCI. The initial excitement after the publication of the TAPAS trial changed the practice paradigm among interventional community worldwide. Aspiration thrombectomy was recommended by several society guidelines and became the "standard of care" during primary PCI. However, recent data and publication of two large randomized controlled trials questioned the effectiveness (TASTE trial) and the safety (TOTAL trial) of this technique. Therefore, the recent ACC/AHA/SCAI-focused update document recommended against the routine use of manual thrombectomy during primary PCI. This review will summarize recent da...Continue Reading

References

Feb 19, 2002·Journal of the American College of Cardiology·Gregg W StoneMartin B Leon
Jan 31, 2007·The American Journal of Cardiology·Fernando A CuraUNKNOWN PREMIAR Investigators
Apr 3, 2007·The American Journal of Cardiology·Victor GuettaUNKNOWN UpFlow MI Study Investigators
Feb 8, 2008·The New England Journal of Medicine·Tone SvilaasFelix Zijlstra
Jun 18, 2011·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Maarten A VinkFerdinand Kiemeneij
Jun 6, 2013·Circulation. Cardiovascular Interventions·Guido ParodiDavid Antoniucci
Sep 3, 2013·The New England Journal of Medicine·Ole FröbertUNKNOWN TASTE Trial
Sep 2, 2014·The New England Journal of Medicine·Bo LagerqvistStefan K James
Apr 9, 2015·The New England Journal of Medicine·Sanjit S JollyUNKNOWN TOTAL Investigators

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