title: Comparison of the reperfusion efficacy of thrombus aspiration with and without distal protection during primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction.
abstract: We evaluated a hypothesis that thrombus aspiration with distal protection is superior to simple thrombus aspiration in patients treated with primary percutaneous coronary intervention (PCI). A total of 176 consecutive patients with ST-segment elevation myocardial infarction were enrolled in this study and assigned to either the thrombus aspiration group (A, n = 104) or the thrombus aspiration with distal protection group using a filter device system (A + DP, n = 72). We compared the angiographic reperfusion grade, left ventricular (LV) function, and clinical outcomes between the 2 groups. There were no significant differences in age, gender distribution, the onset-to-reperfusion time, the peak levels of creatine kinase, or 6-month mortality between the 2 groups. The rate of achieving a Thrombolysis In Myocardial Infarction flow grade of 3 and a myocardial blush grade of 3 was higher in the A + DP group than in the A group. Among the patients who underwent follow-up catheterization 6 months after PCI (A, n = 62; A + DP, n = 52), there were no significant differences in the LV end-diastolic volume index, LV end-systolic volume index, or LV ejection fraction between the 2 groups at the time of PCI or 6 months after PCI. In conclusion, thrombus aspiration with distal protection may be more effective in initially restoring the coronary blood flow than thrombus aspiration alone, although it may not be superior to thrombus aspiration in preventing LV remodeling or preserving the LV function in patients with ST-segment elevation myocardial infarction.
authors.affiliation: Division of Cardiology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. Electronic address: suteta@nifty.com.
authors.forename: Shinji
authors.initials: S
authors.lastname: Satoh
authors.forename: Hiroko
authors.initials: H
authors.lastname: Inoue
authors.forename: Soichiro
authors.initials: S
authors.lastname: Omura
authors.forename: Emiko
authors.initials: E
authors.lastname: Ejima
authors.forename: Koutastu
authors.initials: K
authors.lastname: Shimozono
authors.forename: Makiko
authors.initials: M
authors.lastname: Hayashi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Mori
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Takenaka
authors.forename: Natsumi
authors.initials: N
authors.lastname: Kawamura
authors.forename: Kotaro
authors.initials: K
authors.lastname: Numaguchi
authors.forename: Etsuo
authors.initials: E
authors.lastname: Mori
authors.forename: Akemi
authors.initials: A
authors.lastname: Asoh
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nakamura
authors.forename: Koji
authors.initials: K
authors.lastname: Hiyamuta
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D057505:Embolic Protection Devices / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods; D062645:Percutaneous Coronary Intervention / Q000379:methods; D012189:Retrospective Studies; D013318:Stroke Volume; D013396:Suction; D017131:Thrombectomy / Q000379:methods*; D016896:Treatment Outcome; D020257:Ventricular Remodeling