title: Quantification of manual thrombus removal in patients with acute coronary syndromes: a study exploiting serial frequency domain-optical coherence tomography.
abstract: OBJECTIVE
  Thrombus aspiration is useful in improving myocardial reperfusion in comparison to conventional percutaneous coronary intervention in patients with acute myocardial infarction. Nonetheless, assessment of thrombus aspiration efficacy is lacking. Aim of this study was to quantify by frequency domain optical coherence tomography (OCT) the amount of thrombus removal in patients with acute coronary syndromes undergoing manual thrombus aspiration, correlating it with the actual size of the retrieved material.
  
  
  METHODS
  Twenty-five consecutive patients with acute coronary syndrome were enrolled. OCT assessment of thrombotic lesions was performed before and after thrombus aspiration and repeated after stent deployment. OCT thrombus assessment was based on an established scoring technique. The aspirated material was analyzed by histology, and its planimetry was correlated with OCT-derived thrombus removal.
  
  
  RESULTS
  The percentage of thrombus removal [(prethrombus aspiration minus post-thrombus aspiration)/(prethrombus aspiration × 100)] was 48.9; the delta measurement of the removed thrombus calculated by OCT correlated well with the planimetry-measured aspirated material (r = 0.56, P < 0.01).
  
  
  CONCLUSIONS
  The present study showed the following: the thrombus score derived by OCT measurements correlated reasonably well with the planimetry measure of surface area of the actual aspirated material; after thrombus aspiration a large amount of residual thrombus can be appreciated at the target lesion site; and tissue components such as cholesterol debris and inflammatory cells can often be retrieved during thrombus aspiration.
authors.affiliation: aCardiology Department, San Giovanni Hospital, Rome, Italy bCentro per la Lotta contro l'Infarto (CLI) Foundation, Rome, Italy cSansavini Foundation, Ravenna, Italy dCentre for Inherited Cardiovascular Diseases, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Policlinico San Matteo, Pavia, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Imola
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Mallus
authors.forename: Vito
authors.initials: V
authors.lastname: Ramazzotti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Manzoli
authors.forename: Luca
authors.initials: L
authors.lastname: Di Vito
authors.forename: Michele
authors.initials: M
authors.lastname: Occhipinti
authors.forename: Alberto
authors.initials: A
authors.lastname: Cremonesi
authors.forename: Eloisa
authors.initials: E
authors.lastname: Arbustini
authors.forename: Francesco
authors.initials: F
authors.lastname: Prati
authors.forename: Mario
authors.initials: M
authors.lastname: Albertucci
mesh_terms: D054058:Acute Coronary Syndrome / Q000601:surgery*; D000368:Aged; D003328:Coronary Thrombosis / Q000473:pathology / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D017131:Thrombectomy; D041623:Tomography, Optical Coherence