Safety of AngioJet thrombectomy in acute ST-segment elevation myocardial infarction: a large, single-center experience.
OBJECTIVE
To determine the clinical outcomes associated with use of AngioJet thrombectomy (AT) during percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI).


BACKGROUND
Embolization of thrombus and atherosclerotic plaque is thought to contribute to sub-optimal myocardial reperfusion and worse clinical outcomes in STEMI. However, in a recent randomized trial, a higher mortality and infarct size was observed in patients treated with AT.


METHODS
We performed a retrospective analysis of all patients who underwent primary or rescue PCI for STEMI between January 2000 and December 2005. Angiographic, procedural and in-hospital outcomes were compared between patients treated with or without AT.


RESULTS
1,260 STEMI patients underwent primary or rescue PCI at our hospital during the study period. Of these, 239 (19%) underwent adjunctive treatment with AT. Patients treated with AT were more likely to be female, smokers and have a right coronary artery culprit. A slightly lower incidence of thrombolysis in myocardial infarction (TIMI) 3 grade flow was observed in the AT group after PCI (86% vs. 90%, p = 0.04). There was no significant difference in the incidence of in-lab ventricular tachycardia/ventricular fibrillation, vascular complications or transfusion between the study groups. The peak creatine kinase was higher in patients treated with AT. The incidence of in-hospital major adverse cardiac events was 7.5% in the AT group and 9.0% in the control group (p = NS).


CONCLUSIONS
In this large, single-center experience, use of AT during mechanical reperfusion for STEMI was not associated with an increased risk of adverse outcomes. Our data suggest that AT may be performed safely in selected patients with STEMI.
Chinnaiyan
Kavitha M
KM
Division of Cardiology, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
Grines
Cindy L
CL
O'Neill
William W
WW
Shah
Darshil
D
Raju
Ajitha
A
Decker
Jeffrey
J
Boura
Judith A
JA
Dixon
Simon R
SR
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects*; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D017131:Thrombectomy / Q000009:adverse effects* / Q000379:methods*; D016896:Treatment Outcome