title: Does manual thrombus aspiration help optimize stent implantation in ST-segment elevation myocardial infarction?
abstract: OBJECTIVE
  To evaluate the impact of thrombus aspiration (TA) on procedural outcomes in a real-world ST-segment elevation myocardial infarction (STEMI) registry.
  
  
  METHODS
  From May 2006 to August 2008, 542 consecutive STEMI patients referred for primary or rescue percutaneous coronary intervention were enrolled and the angiographic results and stent implantation characteristics were compared according to the performance of manual TA.
  
  
  RESULTS
  A total of 456 patients were analyzable and categorized in TA group (156 patients; 34.2%) and non-TA (NTA) group (300 patients; 65.8%). Patients treated with TA had less prevalence of multivessel disease (39.7% vs 54.7%, P = 0.003) and higher prevalence of initial thrombolysis in myocardial infarction flow < 3 (P < 0.001) than NTA group. There was a higher rate of direct stenting (58.7% vs 45.5%, P = 0.009), with shorter (24.1 ± 11.8 mm vs 26.9 ± 15.7 mm, P = 0.038) and larger stents (3.17 ± 0.43 mm vs 2.93 ± 0.44 mm, P < 0.001) in the TA group as compared to NTA group. The number of implanted stents (1.3 ± 0.67 vs 1.5 ± 0.84, P = 0.009) was also lower in TA group.
  
  
  CONCLUSIONS
  In an "all-comers" STEMI population, the use of TA resulted in more efficient procedure leading to the implantation of less number of stents per lesion of shorter lengths and larger sizes.
authors.affiliation: Diego Fernández-Rodríguez, Luis Alvarez-Contreras, Victoria Martín-Yuste, Salvatore Brugaletta, Montserrat Cardona, Manel Sabaté, Department of Cardiology, Hospital Clinic, 08036 Barcelona, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Fernández-Rodríguez
authors.affiliation: Diego Fernández-Rodríguez, Luis Alvarez-Contreras, Victoria Martín-Yuste, Salvatore Brugaletta, Montserrat Cardona, Manel Sabaté, Department of Cardiology, Hospital Clinic, 08036 Barcelona, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Alvarez-Contreras
authors.affiliation: Diego Fernández-Rodríguez, Luis Alvarez-Contreras, Victoria Martín-Yuste, Salvatore Brugaletta, Montserrat Cardona, Manel Sabaté, Department of Cardiology, Hospital Clinic, 08036 Barcelona, Spain.
authors.forename: Victoria
authors.initials: V
authors.lastname: Martín-Yuste
authors.affiliation: Diego Fernández-Rodríguez, Luis Alvarez-Contreras, Victoria Martín-Yuste, Salvatore Brugaletta, Montserrat Cardona, Manel Sabaté, Department of Cardiology, Hospital Clinic, 08036 Barcelona, Spain.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.affiliation: Diego Fernández-Rodríguez, Luis Alvarez-Contreras, Victoria Martín-Yuste, Salvatore Brugaletta, Montserrat Cardona, Manel Sabaté, Department of Cardiology, Hospital Clinic, 08036 Barcelona, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Ferreira
authors.affiliation: Diego Fernández-Rodríguez, Luis Alvarez-Contreras, Victoria Martín-Yuste, Salvatore Brugaletta, Montserrat Cardona, Manel Sabaté, Department of Cardiology, Hospital Clinic, 08036 Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: De Antonio
authors.affiliation: Diego Fernández-Rodríguez, Luis Alvarez-Contreras, Victoria Martín-Yuste, Salvatore Brugaletta, Montserrat Cardona, Manel Sabaté, Department of Cardiology, Hospital Clinic, 08036 Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Cardona
authors.affiliation: Diego Fernández-Rodríguez, Luis Alvarez-Contreras, Victoria Martín-Yuste, Salvatore Brugaletta, Montserrat Cardona, Manel Sabaté, Department of Cardiology, Hospital Clinic, 08036 Barcelona, Spain.
authors.forename: Vicens
authors.initials: V
authors.lastname: Martí
authors.affiliation: Diego Fernández-Rodríguez, Luis Alvarez-Contreras, Victoria Martín-Yuste, Salvatore Brugaletta, Montserrat Cardona, Manel Sabaté, Department of Cardiology, Hospital Clinic, 08036 Barcelona, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: García-Picart
authors.affiliation: Diego Fernández-Rodríguez, Luis Alvarez-Contreras, Victoria Martín-Yuste, Salvatore Brugaletta, Montserrat Cardona, Manel Sabaté, Department of Cardiology, Hospital Clinic, 08036 Barcelona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Sabaté
keywords: Manual thrombus aspiration; Primary percutaneous coronary intervention; ST-segment elevation myocardial infarction; Stent; Thrombolysis in myocardial infarction flow