[Diver CE versus Guardwire Plus for thrombectomy during primary angioplasty for inferior myocardial infarction]

In this randomized prospective single-center study, we compared the efficacy of adjunctive thrombectomy using Diver CE device (Linvatec, Italy) versus Guardwire Plus device (Medtronic, USA) before percutaneous coronary intervention (PCI) in patients with <12 h acute inferior myocardial infarction (AIMI) and Thrombolysis In Myocardial Infarction (TIMI) flow grade 0 to 1. The primary end point was the magnitude of ST-segment resolution after PCI.

A total of 122 patients (61 in Diver CE group and 61 in Guardwire Plus group) were studied. The magnitude of ST-segment resolution, myocardial blush grade and slow flow or no re-flow 1 h after PCI were measured in study patients.

Baseline characteristics were similar between groups: age (59.6 +/- 14 years vs. 60.1 +/- 13 years), males (82% vs. 84%), diabetes (31% vs. 28%), previous coronary artery disease (25% vs. 23%), onset-to-angiogram (350 +/- 185 min vs. 345 +/- 180 min), and glycoprotein IIb/IIIa inhibitor use (11% vs. 13%, all P > 0.05). The magnitude of ST-segment resolution was also similar in these two groups: ST-segment resolution > 70% (57% vs. 59%, P > 0.05). Slow flow/no reflow rate (8% vs. 7%), TIMI flow grade 3 (95% vs. 97%) and myocardial blush grade 3 (70% vs. 72%) post PCI were not different in the groups (all P > 0.05). Left ventricle ejection fraction (0.54 +/- 0.12 vs. 0.53 +/- 0.11), death (3% vs. 3%), re-myocardial infarction (2% vs. 0) and target vessel revascularization (2% vs. 2%) at one month post PCI were comparable (all P > 0.05).

Efficacy of removing thrombus burden with Diver CE device or Guardwire Plus device was similar in patients with < 12 h acute inferior myocardial infarction.