JETSTENT trial results: impact on ST-segment elevation myocardial infarction interventions.
The results of meta-analyses of studies on manual thrombus aspiration and mechanical thrombectomy support the use of manual aspiration catheters and contraindicate the use of mechanical thrombectomy devices. However, the two largest studies dominate the meta-analysis results, the Thrombus Aspiration during Percutaneous Coronary Intervention in Acute Myocardial Infarction Study (TAPAS) for the manual aspiration study group, and the Angiojet rheolytic thrombectomy In patients undergoing primary angioplasty for acute Myocardial Infarction (AIMI) trial for the mechanical thrombectomy group. The first demonstrated a clinical benefit of thrombus removal using the manual aspiration catheter. The AIMI trial, which included 480 patients, showed a negative and harmful impact on survival of rheolytic thrombectomy. The results of the recently concluded AngioJET Rheolytic Thrombectomy Before Direct Infarct Artery STENTing with Direct Stenting Alone in Patients with Acute Myocardial Infarction (JETSTENT) trial, which included 501 patients and showed a strong clinical benefit of rheolytic thrombectomy in the setting of primary PCI for acute myocardial infarction (AMI), adds new arguments in support of rheolytic thrombectomy in AMI.
Division of Cardiology, Careggi Hospital, Viale Morgagni I-50134 Florence, Italy. david.antoniucci@virgilio.it
David
D
Antoniucci
D015906:Angioplasty, Balloon, Coronary; D003328:Coronary Thrombosis / Q000150:complications / Q000401:mortality / Q000601:surgery*; D004562:Electrocardiography; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015607:Stents; D013396:Suction / Q000295:instrumentation / Q000379:methods; D017131:Thrombectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*