Related Experiment Video

Updated: Jul 7, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Adjunct thrombus aspiration reduces mortality in patients undergoing percutaneous coronary intervention for

Aamir Javaid1, Nauman H Siddiqi, Daniel H Steinberg

  • 1Division of Cardiology, Washington Hospital Center, Washington, DC, USA.

The American Journal of Cardiology
|March 4, 2008
PubMed

Insights

Aspiration thrombectomy (AT) improved outcomes for ST-segment elevation myocardial infarction (STEMI) patients with poor blood flow or visible thrombus. This intervention led to better flow, less residual thrombus, and reduced major adverse cardiac events and mortality.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Acute Coronary Syndromes

Background:

  • Routine aspiration thrombectomy (AT) in ST-segment elevation myocardial infarction (STEMI) has shown limited efficacy in randomized trials.
  • However, AT remains a consideration for STEMI patients with severely reduced flow or visible thrombus during primary percutaneous coronary intervention (PCI).

Purpose of the Study:

  • To evaluate the effectiveness of adjunctive AT in a high-risk STEMI cohort undergoing primary PCI.
  • To compare outcomes between patients treated with AT and those treated with PCI alone.

Main Methods:

  • A retrospective analysis of 158 STEMI patients with Thrombolysis In Myocardial Infarction (TIMI) 0-1 flow or visible thrombus.
  • 80 patients received AT as an adjunct to primary PCI, while 78 underwent PCI without AT.
  • Comparison of TIMI 3 flow, residual thrombus, and major adverse cardiac events (MACE) at 30 days, 6 months, and 1 year.

Main Results:

  • The AT group achieved significantly higher TIMI 3 flow post-PCI (91.3% vs 67.9%, p <0.001).
  • Less residual thrombus was observed in the AT group (7.5% vs 19.2%, p = 0.03).
  • AT was associated with reduced MACE at 6 months (6.8% vs 24.0%, p = 0.004) and 1 year (16.6% vs 29.2%, p = 0.009), and lower mortality rates at 6 months (5.4% vs 21.3%, p = 0.004) and 1 year (7.7% vs 26.2%, p = 0.005).

Conclusions:

  • Adjunctive aspiration thrombectomy in STEMI patients with TIMI 0-1 flow or visible thrombus improves coronary blood flow and reduces residual thrombus.
  • AT is associated with significantly decreased major adverse cardiac events and mortality in this high-risk STEMI population.

Related Concept Videos

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...