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Thrombus Profiling Assay: A Microfluidics-Based Platform for Comprehensively Characterizing Biomechanical Thrombogenesis
Published on: January 9, 2026
A comparison of 2 thrombus aspiration devices with histopathological analysis of retrieved material in patients
Pieter J Vlaar1, Tone Svilaas, Mathijs Vogelzang
1Department of Cardiology, University Medical Centre Groningen, University of Groningen, the Netherlands. p.j.j.vlaar@thorax.umcg.nl
Insights
A larger catheter lumen did not improve thrombus aspiration in ST-segment elevation myocardial infarction patients. Catheter size did not affect particle size or clinical outcomes in this comparison.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomedical Engineering
Background:
- Distal embolization is a frequent complication during percutaneous coronary intervention for ST-segment elevation myocardial infarction, potentially impairing myocardial perfusion.
- Aspiration thrombectomy devices aim to mitigate distal embolization, but clinical results vary, with device-specific factors like lumen size being a potential explanation.
Purpose of the Study:
- To compare the efficacy of two manual thrombus aspiration catheters with different internal lumen sizes in unselected ST-segment elevation myocardial infarction patients.
- To investigate if a larger internal lumen diameter influences the size of retrieved thrombotic particles and clinical outcomes.
Main Methods:
- A prospective cohort study involving 160 patients undergoing primary percutaneous coronary intervention.
- Patients were treated with either a large-internal-lumen catheter (Diver) or a medium-sized catheter (Export) from the TAPAS trial.
- Histopathological analysis of retrieved material was performed.
Main Results:
- Effective thrombus aspiration occurred in 70.3% with the Diver catheter versus 81.8% with the Export catheter (p=0.10).
- No significant differences were observed in myocardial blush grade or electrocardiographic outcomes between the two devices.
- Thrombotic particle size distribution was similar, and erythrocyte-rich thrombi were associated with low initial Thrombolysis In Myocardial Infarction flow grade.
Conclusions:
- A larger internal lumen diameter of aspiration catheters does not lead to the retrieval of larger thrombotic particles.
- Catheter size did not significantly impact angiographic or electrocardiographic outcomes in this patient cohort.
Objectives:
The objective of this study was to compare 2 manual thrombus aspiration catheters in unselected patients with ST-segment elevation myocardial infarction.
Background:
Distal embolization is common during percutaneous coronary intervention in ST-segment elevation myocardial infarction and can induce impaired myocardial perfusion. Several aspiration thrombectomy devices have been introduced to prevent distal embolization, however, with conflicting clinical results. Currently, it is unclear to what extent this variance in outcome can be explained by device-related factors, such as internal lumen size.
Methods:
We performed a prospective cohort study in which patients undergoing primary percutaneous coronary intervention were treated with a large-internal-lumen catheter (Diver, Invatec, Roncadelle, Italy). Outcomes were compared with a matched population of the Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study (TAPAS) trial, in which patients were treated with a medium-sized catheter (Export, Medtronic, Minneapolis, Minnesota). A histopathological analysis was performed of retrieved material.
Results:
A total of 160 patients, treated with the Diver (n = 80) or Export (n = 80) aspiration catheter, were enrolled. Effective thrombus aspiration was seen in 70.3% of the patients treated with the Diver catheter versus 81.8% with the Export catheter (p = 0.10) No significant difference was found in myocardial blush grade or electrocardiographic outcome between the 2 devices. Size distribution of retrieved thrombotic particles was similar per device. Erythrocyte-rich thrombi were found in 34.8% of the cases and were predominately seen in patients with low initial Thrombolysis In Myocardial Infarction flow grade (p = 0.008).
Conclusions:
A larger internal lumen diameter does not result in retrieval of larger thrombotic particles, nor in improved angiographic or electrocardiographic outcomes.
