PMID- 29588672
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240315
IS  - 1756-1477 (Print)
IS  - 1756-1485 (Electronic)
IS  - 1756-1485 (Linking)
VI  - 10
IP  - 1
DP  - 2015 Mar
TI  - Interventional Strategies in Thrombus Management for ST Elevation Myocardial 
      Infarction.
PG  - 35-38
LID - 10.15420/icr.2015.10.1.35 [doi]
AB  - The major limitation of modern primary percutaneous coronary intervention (PPCI) 
      is distal embolisation of thrombus and microvascular obstruction. Microvascular 
      flow, as measured by myocardial blush grade (MPG), predicts mortality after PPCI. 
      Despite initial enthusiasm, current evidence does not support routine use of 
      Intracoronary over intravenous glycoprotein 2b3a inhibitors during PPCI for ST 
      elevation myocardial infarction (STEMI) to improve clinical outcomes. Manual 
      thrombectomy (MT) improves MPG and reduces distal embolisation in meta-analyses 
      of small trials. A single-centre trial (N=1071), the Thrombus aspiration during 
      percutaneous coronary intervention in acute myocardial infarction study (TAPAS) 
      trial showed a mortality reduction, which led guidelines to recommend routine 
      manual aspiration. However, the largest randomised trial (Thrombus aspiration in 
      ST-elevation myocardial infarction in Scandinavia [TASTE] trial, N=7021) showed 
      no difference in mortality and only trends towards reduction in myocardial 
      infarction (MI) and stent thrombosis. The TASTE trial had much lower than 
      expected mortality and so was likely underpowered for modest but important 
      treatment effects (20-30 % RRR). The Thrombectomy with PCI versus PCI alone in 
      patients with STEMI undergoing primary PCI (TOTAL) trial (N=10,700) will 
      determine if MT reduces important clinical events during PPCI. Thrombus 
      management remains an important area of research in STEMI.
FAU - Tsang, Michael
AU  - Tsang M
AD  - Interventional Cardiology Fellow.
FAU - Jolly, Sanjit
AU  - Jolly S
AD  - Associate Professor, McMaster University and Population Health Research 
      Institute,Hamilton Health Sciences, Hamilton, Canada.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Interv Cardiol
JT  - Interventional cardiology (London, England)
JID - 101559687
PMC - PMC5808725
OTO - NOTNLM
OT  - Primary percutaneous intervention
OT  - ST elevation myocardial infarction
OT  - interventional strategies
OT  - microvascular perfusion
OT  - thrombus thombectomy
COIS- Disclosure: The authors have no conflicts of interest to declare.
EDAT- 2015/03/01 00:00
MHDA- 2015/03/01 00:01
PMCR- 2015/03/01
CRDT- 2018/03/29 06:00
PHST- 2018/03/29 06:00 [entrez]
PHST- 2015/03/01 00:00 [pubmed]
PHST- 2015/03/01 00:01 [medline]
PHST- 2015/03/01 00:00 [pmc-release]
AID - 10.15420/icr.2015.10.1.35 [doi]
PST - ppublish
SO  - Interv Cardiol. 2015 Mar;10(1):35-38. doi: 10.15420/icr.2015.10.1.35.