Safety of primary percutaneous coronary intervention with and without (selective) thrombus aspiration

To determine the safety and efficacy of selective thrombus aspiration during Primary Percutaneous Coronary Intervention (PCI). This observational prospective study was conducted in the catheterization laboratory of a tertiary care cardiovascular centre. A total of 150 consecutive patients who underw...

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Bibliographic Details
Published in:Journal of the Pakistan Medical Association 2014-06, Vol.64 (6), p.653-659
Main Authors: Farman, Muhammad Tariq, Saghir, Tahir, Rizvi, Nadeem Hasan, Sial, Jawaid Akbar, Khan, Naveedullah, Malik, Abdul, Zaman, Khan Shah
Format: Article
Language:English
Subjects:
Blood clot
Coronary Angiography
Coronary Thrombosis - diagnostic imaging
Coronary Thrombosis - therapy
Electrocardiography
Female
Humans
Male
Middle Aged
Myocardial Infarction - therapy
Patient Safety
Percutaneous Coronary Intervention
Prospective Studies
Risk Factors
Thrombolytic Therapy
Thrombosis
Transluminal angioplasty
Treatment Outcome
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Summary:To determine the safety and efficacy of selective thrombus aspiration during Primary Percutaneous Coronary Intervention (PCI). This observational prospective study was conducted in the catheterization laboratory of a tertiary care cardiovascular centre. A total of 150 consecutive patients who underwent primary PCI were enrolled. Aspiration was done only when thrombus burden was considered significant. After completion of procedure angiographic and electrocardiographic signs were recorded and clinical follow up was documented up to 1 year. No significant difference among the groups was found in age, height, weight and other risk factors like Hypertension, Diabetes Mellitus and Smoking. In general, left anterior descending artery was culprit in - 65% of patients and more than 90% of culprit vessels had visible thrombus. Multivessel disease was present in 38% of patients and 22.7% had past history of myocardial infarction. Out of 150 patients 117 (78%) underwent thrombus aspiration. No significant difference was found in ST resolution within 60 minutes (72.6 vs 81.8%; P < 0.285) and myocardial blush grade II & III (41.9 vs 27.3%; P < 0.128). No difference in event free survival was observed among the two groups (80.3 vs 84.8%; P < 0.708) at one year. Selective thrombus aspiration in definite thrombus laden arteries and no aspiration in low or negligible thrombus burden vessels may be a safe and effective strategy in patients undergoing primary PCI. Overall poor risk profile of our patients as compared to western population necessitates further evaluation of this matter in randomized studies.
ISSN:0030-9982