title: Optical coherence tomography assessment of efficacy of thrombus aspiration in patients undergoing a primary percutaneous coronary intervention for acute ST-elevation myocardial infarction.
abstract: OBJECTIVE
  We used optical coherence tomography (OCT) to assess the impact of thrombus aspiration before angioplasty on poststenting tissue protrusions in patients undergoing a primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI).
  
  
  RESULTS
  A total of 188 patients with STEMI who underwent thrombus-aspiration PCI (n=113) or standard PCI (n=75) were examined in this study. OCT was performed immediately after primary PCI to assess lesion morphology in the stented segment. The minimum stent area was similar between the thrombus-aspiration PCI group and the standard PCI group [7.4 interquartile range (IQR): 5.8-9.4 vs. 7.4 IQR: 5.8-8.9 mm², P=0.788]. The maximum tissue protrusion area [0.6 (IQR: 0.3-1.1) vs. 1.2 (IQR: 0.8-1.9) mm², P<0.001], the mean tissue protrusion area [0.1 (IQR: 0.1-0.2) vs. 0.5 (IQR: 0.3-0.8) mm², P<0.001], and tissue protrusion volume [2.3 (IQR: 1.3-4.3) vs. 8.3 (IQR: 5.4-14.6) mm², P<0.001] were significantly smaller in the thrombus-aspiration PCI group compared with the standard PCI group. Minimum lumen area was significantly greater in the thrombus-aspiration PCI group compared with the standard PCI group [6.9 (IQR: 5.4-8.8) vs. 6.3 (IQR: 4.6-7.8) mm², P=0.033].
  
  
  CONCLUSIONS
  Thrombus aspiration before angioplasty in patients with STEMI was associated with significantly smaller tissue protrusion and larger lumen poststenting compared with standard PCI. Thrombus aspiration in primary PCI favorably influenced lesion morphologies in the stented segment.
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Kubo
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ino
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Matsuo
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Shiono
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamano
authors.forename: Akira
authors.initials: A
authors.lastname: Taruya
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Nishiguchi
authors.forename: Aiko
authors.initials: A
authors.lastname: Shimokado
authors.forename: Makoto
authors.initials: M
authors.lastname: Orii
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hozumi
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
mesh_terms: D000368:Aged; D003328:Coronary Thrombosis / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents; D017131:Thrombectomy / Q000379:methods*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome