title: Clinical Outcomes of Manual Aspiration Thrombectomy in Patients with Acute Myocardial Infarction: An Updated Meta-Analysis.
abstract: BACKGROUND
  Recent trials on manual aspiration thrombectomy (AT) in patients with ST-elevation myocardial infarction did not show any significant benefits of AT.
  
  
  OBJECTIVE
  The present meta-analysis was designed to systematically evaluate prospective randomized trials and assess the effects of AT on all-cause mortality, major cardiovascular events (MACE), target vessel revascularization, myocardial reinfarction, stroke and surrogate myocardial perfusion markers.
  
  
  RESULTS
  We conducted an EMBASE and MEDLINE search for studies in which patients were randomized to treatment with AT plus primary percutaneous coronary intervention (PCI) versus PCI. We identified 16 prospective randomized trials which enrolled 10,437 controls that underwent conventional PCI and 10,385 patients who underwent PCI with AT with an average follow-up duration of 5.8 months. A significant reduction in MACE with AT was noted (OR 0.91; 95% CI 0.82-0.99; p = 0.04). In spite of improved TIMI 3 and myocardial blush grade 3 rates, AT did not significantly reduce all-cause mortality, target-vessel revascularization and myocardial infarction. Stroke rates were increased with AT.
  
  
  CONCLUSIONS
  The results of this large meta-analysis of 20,822 patients suggest that adjunctive AT to PCI may be associated with improved myocardial reperfusion but limited benefits related to the clinical end-points. © 2015 S. Karger AG, Basel.
authors.affiliation: Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, Ill., USA.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Briasoulis
authors.forename: Mohan
authors.initials: M
authors.lastname: Palla
authors.forename: Luis
authors.initials: L
authors.lastname: Afonso