Background:
A few studies (TAPAS, INFUSE-AMI and TASTE trial) checked a hypothesis weather routine intracoronary thrombus aspiration reduce mortality but had different study design and follow up and have shown different results. However, the majority of invasive cardiologists still performing thrombus aspiration in the setting of acute ST elevation myocardial infarction (STEMI) since they believe that it may improve a flow. The aim of this study is to analyze the influence of the intracoronary thrombus aspiration on TIMI flow in patients with acute STEMI.
Patients& Methods:
A prospective cohort analysis of 127 STEMI consecutive patients who underwent primary percutaneous coronary Intervention (PPCI) at our institution during the last year; age 55.8 ± 12.9 years, 79.7% males. The decision weather to perform thrombus aspiration was taken by interventional cardiologist. TIMI flow before and after PPCI was compared in two groups: the patients in whom intracoronary thrombus aspiration was performed before PPCI and those that underwent PPCI without thrombus aspiration.
Results:
Intracoronary thrombus aspiration was performed in 65 patients and 62 patients underwent PPCI without thrombus aspiration. The thrombus was successfully aspirated in 70.8% of patients. Median TIMI flow before PPCI in the aspiration group was TIMI= 0, [Interquartile Range (IQR) 0; 1] whereas in the group without aspiration median TIMI flow before the PPCI was 3, [IQR , 1; 3]. Though the median TIMI flow after PPCI was 3, [IQR, 3; 3] in both groups, the difference between the TIMI before and after PPCI was significantly higher in the thrombus aspiration group than in group without thrombus aspiration ,median TIMI change = 3[ IQR, 2;3] vs. 0[ 0;1], p=0.001.
Conclusion:
Intracoronary thrombus aspiration may improve the TIMI flow in the infarct related artery
