title: COmparison between COronary THrombus aspiration with Angiojet® or Export® catheter in patients with ST-elevation myocardial infarction submitted to primary angioplasty: The COCOTH Study.
abstract: OBJECTIVE
  To compare the effects of two thrombus aspiration devices, the manual catheter Export® and the more complex and expensive mechanical Angiojet®, on several indices of reperfusion in acute ST-elevation myocardial infarction (STEMI).
  
  
  RESULTS
  Clinical, hemodynamic and procedural characteristics of 185 STEMI patients, randomized to treatment with Export (n=95) or Angiojet (n=90) during primary percutaneous coronary intervention (PPCI) were analyzed. The primary endpoint was ST-segment elevation reduction 90 min after culprit vessel re-opening. Secondary endpoints included variations in some angiographic parameters (TIMI Flow, TIMI Frame Count and Myocardial Blush Grade) and Infarct Size and Severity at myocardial scintigraphy. A significant reduction in ST-elevation was observed in both groups after PPCI without significant differences between the two groups. No significant difference between Angiojet vs. Export was observed in ST-segment resolution >50% and ≥ 70%, in TIMI Flow, TIMI Frame Count and Myocardial Blush Grade before vs. after PPCI and in Infarct Size and Severity.
  
  
  CONCLUSIONS
  PPCI with thrombus aspiration was effective in both groups of patients, without differences in myocardial reperfusion and necrosis indices. These results could support the routine use of manual devices during PPCI, reserving the more expensive Angiojet in case of manual device failure and persistent or massive intracoronary thrombosis, with favorable implications in terms of cost containment.
authors.affiliation: Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy. Electronic address: cristinagiglioli@yahoo.it.
authors.forename: Cristina
authors.initials: C
authors.lastname: Giglioli
authors.affiliation: Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cecchi
authors.affiliation: Nuclear Medicine Unit, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Sciagrá
authors.affiliation: Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Giorgio Jacopo
authors.initials: GJ
authors.lastname: Baldereschi
authors.affiliation: Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Meucci
authors.affiliation: Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Serafina
authors.initials: S
authors.lastname: Valente
authors.affiliation: Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Chiostri
authors.affiliation: Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
authors.affiliation: Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Spini
authors.affiliation: Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Landi
authors.affiliation: Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Salvatore Mario
authors.initials: SM
authors.lastname: Romano
authors.affiliation: Nuclear Medicine Unit, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Calabretta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000379:methods*; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D004562:Electrocardiography; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D017131:Thrombectomy / Q000295:instrumentation*; D016896:Treatment Outcome
keywords: Primary angioplasty; STEMI; Thrombus aspiration