title: Urgent PCI in patients with stent thrombosis: an observational single-center study comparing thrombus aspiration and standard PCI.
abstract: OBJECTIVE
  Stent thrombosis (ST) is a recognized complication of percutaneous coronary interventions (PCI). Due to the high thrombus burden present in ST, the use of thrombus aspiration (TA) may enhance the angiographic results by limiting distal embolization.
  
  
  METHODS
  Consecutive patients undergoing urgent PCI due to ST were studied, consisting of two groups according to the type of intervention (standard PCI [SP] or TA). TIMI flow, corrected TIMI frame count (cTFC), myocardial blush grade (MBG), thrombus score (TS), Yip's adverse thrombus burden features, occurrence of angiographically evident distal embolization (DE) were evaluated offline. In-hospital outcomes were also recorded.
  
  
  RESULTS
  Twenty-eight patients entered the study. Baseline clinical and angiographic features were similar between patients treated by SP (n = 12) and those treated by TA (n = 16). After PCI, a trend in favor of TA as compared to SP was observed for post-PCI TIMI 3 flow rate (67% vs. 89%; p = 0.10), final cTFC (31 +/- 35 vs. 17 +/- 21; p = 0.10) and MBG 2-3 rate (40% vs. 67%; p = 0.12). Accordingly, the rate of adverse angiographic outcome (post-PCI TIMI 0-1 flow and/or DE) was significantly lower in the TA as compared to SP: 5% (1 out of 18) vs. 33% (5 out of 15) respectively (p = 0.04). Throughout hospitalization, major adverse events occurred in 6% of TA patients vs. 33% of SP patients (p = 0.08).
  
  
  CONCLUSIONS
  TA in patients with ST is safe and is associated with better angiographic outcomes compared to standard PCI. Larger studies are warranted to confirm these early observations.
authors.affiliation: Institute of Cardiology, Catholic University, Via B. Barbiellini Amidei, 80, 00168, Rome, Italy. mariarosariadevita77@libero.it
authors.forename: Maria
authors.initials: M
authors.lastname: De Vita
authors.forename: Francesco
authors.initials: F
authors.lastname: Burzotta
authors.forename: Carlo
authors.initials: C
authors.lastname: Trani
authors.forename: Enrico
authors.initials: E
authors.lastname: Romagnoli
authors.forename: Giovanni Paolo
authors.initials: GP
authors.lastname: Talarico
authors.forename: Italo
authors.initials: I
authors.lastname: Porto
authors.forename: Antonio Maria
authors.initials: AM
authors.lastname: Leone
authors.forename: Giuseppe G L
authors.initials: GG
authors.lastname: Biondi-Zoccai
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Niccoli
authors.forename: Antonio Giuseppe
authors.initials: AG
authors.lastname: Rebuzzi
authors.forename: Rocco
authors.initials: R
authors.lastname: Mongiardo
authors.forename: Mario Attilio
authors.initials: MA
authors.lastname: Mazzari
authors.forename: Giovanni
authors.initials: G
authors.lastname: Schiavoni
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D000925:Anticoagulants / Q000627:therapeutic use; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D017131:Thrombectomy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006493:Heparin