title: Comparison of rheolytic thrombectomy before direct infarct artery stenting versus direct stenting alone in patients undergoing percutaneous coronary intervention for acute myocardial infarction.
abstract: This randomized trial compared rheolytic thrombectomy before direct infarct artery stenting with direct infarct artery stenting alone in 100 patients with a first acute myocardial infarction (AMI). The primary end point of the study was early ST-segment elevation resolution, and the secondary end points were corrected Thrombolysis In Myocardial Infarction (TIMI) frame count, infarct size, and 1-month clinical outcome. The primary end point rates were 90% in the thrombectomy group and 72% in the placebo group (p = 0.022). Randomization to thrombectomy was independently related to the primary end point (odds ratio 3.56, p = 0.032). The corrected Thrombolysis In Myocaridal Infarctions (TIMI) frame count was lower in the thrombectomy group (18.2 +/- 7.7 vs 22.5 +/- 11.0, p = 0.032), and infarct size was smaller in the thrombectomy group (13.0 +/- 11.6% vs 21.2 +/- 18.0%, p = 0.010). At 1 month, there were no major adverse cardiac events. Rheolytic thrombectomy before routine direct infarct-related artery (IRA) stenting is highly feasible and provides more effective myocardial reperfusion in patients undergoing percutaneous coronary intervention for AMI.
authors.affiliation: Division of Cardiology, Careggi Hospital, Florence, Italy. cardddept@tin.it
authors.forename: David
authors.initials: D
authors.lastname: Antoniucci
authors.forename: Renato
authors.initials: R
authors.lastname: Valenti
authors.forename: Angela
authors.initials: A
authors.lastname: Migliorini
authors.forename: Guido
authors.initials: G
authors.lastname: Parodi
authors.forename: Gentian
authors.initials: G
authors.lastname: Memisha
authors.forename: Giovanni Maria
authors.initials: GM
authors.lastname: Santoro
authors.forename: Roberto
authors.initials: R
authors.lastname: Sciagrà
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D019919:Prosthesis Implantation / Q000379:methods; D015607:Stents; D017131:Thrombectomy / Q000379:methods*