Sucking Out a Coronary Thrombus Before Stenting Seems Worthwhile

Previous work in The Netherlands has shown that percutaneous coronary intervention (PCI) can induce embolization of atherothrombotic material with resulting impaired myocardial reperfusion, and that thrombus aspiration before stenting can prevent this effect.

In this study, reported in The Lancet in 2008,[1] 12 investigators analyzed, by intention to treat, cardiac death or nonfatal myocardial reinfarction after 1 year in 1060 randomized patients.
In the group treated by conventional PCI, 6.7% suffered cardiac death vs only 3.6% in the thrombus aspiration group; the data for cardiac death or nonfatal reinfarction after 1 year were 5.6% vs 9.9%.
The intuitively sensible action of aspirating thrombus in acute myocardial infarction prior to stenting is supported by data.

This article is selected from Medscape Best Evidence. Dr George Lundberg.


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