title: Safety of primary percutaneous coronary intervention with and without (selective) thrombus aspiration.
abstract: OBJECTIVE
  To determine the safety and efficacy of selective thrombus aspiration during Primary Percutaneous Coronary Intervention (PCI).
  
  
  METHODS
  This observational prospective study was conducted in the catheterization laboratory of a tertiary care cardiovascular centre. A total of 150 consecutive patients who underwent primary PCI were enrolled. Aspiration was done only when thrombus burden was considered significant. After completion of procedure angiographic and electrocardiographic signs were recorded and clinical follow up was documented up to 1 year.
  
  
  RESULTS
  No significant difference among the groups was found in age, height, weight and other risk factors like Hypertension, Diabetes Mellitus and Smoking. In general, left anterior descending artery was culprit in - 65% of patients and more than 90% of culprit vessels had visible thrombus. Multivessel disease was present in 38% of patients and 22.7% had past history of myocardial infarction. Out of 150 patients 117 (78%) underwent thrombus aspiration. No significant difference was found in ST resolution within 60 minutes (72.6 vs 81.8%; P < 0.285) and myocardial blush grade II & III (41.9 vs 27.3%; P < 0.128). No difference in event free survival was observed among the two groups (80.3 vs 84.8%; P < 0.708) at one year.
  
  
  CONCLUSIONS
  Selective thrombus aspiration in definite thrombus laden arteries and no aspiration in low or negligible thrombus burden vessels may be a safe and effective strategy in patients undergoing primary PCI. Overall poor risk profile of our patients as compared to western population necessitates further evaluation of this matter in randomized studies.
authors.forename: Muhammad Tariq
authors.initials: MT
authors.lastname: Farman
authors.forename: Tahir
authors.initials: T
authors.lastname: Saghir
authors.forename: Nadeem Hasan
authors.initials: NH
authors.lastname: Rizvi
authors.forename: Jawaid Akbar
authors.initials: JA
authors.lastname: Sial
authors.forename: Naveedullah
authors.initials: N
authors.lastname: Khan
authors.forename: Abdul
authors.initials: A
authors.lastname: Malik
authors.forename: Khan Shah
authors.initials: KS
authors.lastname: Zaman
mesh_terms: D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000628:therapy*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D061214:Patient Safety; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D012307:Risk Factors; D015912:Thrombolytic Therapy; D016896:Treatment Outcome