title: An international survey of clinical practice during primary percutaneous coronary intervention for ST-elevation myocardial infarction with a focus on aspiration thrombectomy.
abstract: OBJECTIVE
  Data suggest that there is a variable use of thrombectomy during primary percutaneous coronary interventions (PPCI). We sought to evaluate practices during PPCI for ST-elevation myocardial infarction (STEMI), including the use of aspiration thrombectomy, and to determine the feasibility of conducting a definitive aspiration thrombectomy trial.
  
  
  RESULTS
  A 27-item online survey was distributed to 1,607 interventional cardiologists internationally. A total of 461 responses were received. During PPCI, aspiration thrombectomy is used routinely by 36% of respondents, and selectively by 60%. Twenty-five percent of respondents reported experiencing a complication related to thrombectomy including: vessel dissection (13%), bringing thrombus back into left main coronary artery from target vessel (5%), stroke or transient ischaemic attack (2%), and coronary artery perforation (1%). The vast majority of respondents (89%) believe that a confirmatory aspiration thrombectomy trial is needed and 85% would be willing to randomise patients in such a trial.
  
  
  CONCLUSIONS
  The majority of interventional cardiologists surveyed are not using thrombectomy routinely during PPCI. The survey results suggest that a large, confirmatory thrombectomy trial is needed and feasible in the current era. The survey also highlights a significant level of variability and underutilisation of other evidence-based therapies during PPCI.
authors: University of Toronto, Toronto, Ontario, Canada.
authors: Juan J
authors: JJ
authors: Russo
authors: Vladimír
authors: V
authors: Dzavík
authors: John A
authors: JA
authors: Cairns
authors: Sunil V
authors: SV
authors: Rao
authors: Kari O
authors: KO
authors: Niemelä
authors: Madhu K
authors: MK
authors: Natarajan
authors: Olivier F
authors: OF
authors: Bertrand
authors: Markku
authors: M
authors: Eskola
authors: Robert
authors: R
authors: Welsh
authors: Pawel
authors: P
authors: Maciejewski
authors: Asim N
authors: AN
authors: Cheema
authors: Anthony
authors: A
authors: Fung
authors: Warren J
authors: WJ
authors: Cantor
authors: Shahar
authors: S
authors: Lavi
authors: Petr
authors: P
authors: Widimsky
authors: Sanjit S
authors: SS
authors: Jolly
mesh_terms: D002309:Cardiology; D003625:Data Collection; D004562:Electrocardiography; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D017131:Thrombectomy / Q000009:adverse effects / Q000379:methods*