Impact of Thrombus Burden on Outcomes After Standard Versus Mesh-Covered Stents in Acute Myocardial Infarction (from the MGuard for Acute ST Elevation Reperfusion Trial)

• Published in: The American journal of cardiology 2015-01, Vol.115 (2), p.161-166
• Main Authors: Costa, Ricardo A., MD, PhD, Abizaid, Alexandre, MD, PhD, Lotan, Chaim, MD, Dudek, Dariusz, MD, PhD, Silber, Sigmund, MD, Dizon, Jose M., MD, Maehara, Akiko, MD, Dressler, Ovidiu, MD, Brener, Sorin J., MD, Stone, Gregg W., MD
• Format: Article
• Language: English
• Subjects: Blood clots; Cardiology; Cardiovascular; Coronary Angiography; Drug delivery; Drug-Eluting Stents; Electrocardiography; Female; Graft Occlusion, Vascular - diagnosis; Graft Occlusion, Vascular - etiology; Graft Occlusion, Vascular - prevention & control; Heart attacks; Humans; Implants; Laboratories; Lesions; Male; Middle Aged; Morphology; Myocardial infarction; Myocardial Infarction - diagnosis; Myocardial Infarction - surgery; Percutaneous Coronary Intervention - methods; Prognosis; Prosthesis Design; Reperfusion; Segments; Stents; Success; Thrombolysis; Thrombosis
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2014.10.016

Large thrombus burden negatively affects the results of percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI). We investigated the impact of thrombus burden in patients with STEMI undergoing primary PCI with the mesh-covered MGuard stent (InspireMD Ltd., Tel Aviv, Israel) versus a control bare-metal or drug-eluting stent. In 433 patients with STEMI randomized to the MGuard stent versus a control stent, angiographically visible thrombus was identified in 383 patients (88.5%), with median thrombus area 30.15 mm2 (22.70, 41.93). Lesions with large thrombus (area > median) were treated with more frequent use of manual aspiration (80.8% vs 65.8%, p = 0.0009) and longer (22.1 ± 5.9 vs 19.4 ± 5.4 mm, p