COmparison between COronary THrombus aspiration with Angiojet® or Export® catheter in patients with ST-elevation myocardial infarction submitted to primary angioplasty: The COCOTH Study

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• 作者：Cristina Giglioli^a ; ^{cristinagiglioli@yahoo.it" class="auth_mail" title="E-mail the corresponding author} ; Emanuele Cecchi^a ; Roberto Sciagrá ; ^b ; Giorgio Jacopo Baldereschi^a ; Francesco Meucci^a ; Serafina Valente^a ; Marco Chiostri^a ; Gian Franco Gensini^a ; Valentina Spini^a ; Daniele Landi^a ; Salvatore Mario Romano^a ; Raffaella Calabretta^b
• 关键词：STEMI ; Primary angioplasty ; Thrombus aspiration
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：15 January 2016
• 年：2016
• 卷：203
• 期：Complete
• 页码：757-762
• 全文大小：307 K

文摘

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).

Methods and 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.