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Clinical outcomes associated with failed thrombus aspiration during primary percutaneous coronary intervention

Hasan Sohail1, Kaleem Ullah Bacha, Syed Javaid Iqbal

  • 1Department of Medicine, Ibn e Seena Hospital, Kabul, Afghanistan.

Medicine
|January 7, 2026
PubMed

Insights

Failed thrombus aspiration during primary percutaneous coronary intervention for ST-elevation myocardial infarction (STEMI) is common and linked to worse patient outcomes. Identifying predictors of failure can help improve treatment strategies.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Thrombus aspiration is a key procedure during primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI).
  • The success of thrombus aspiration varies, and failure can negatively impact patient prognosis.

Purpose of the Study:

  • To identify predictors of failed thrombus aspiration in STEMI patients undergoing primary PCI.
  • To evaluate the clinical outcomes associated with failed thrombus aspiration.

Main Methods:

  • Retrospective analysis of 5323 STEMI patients undergoing primary PCI.
  • Comparison of baseline characteristics, angiographic findings, and procedural details between failed and successful aspiration groups.
  • Multivariate logistic regression to determine predictors of aspiration failure; one-year clinical outcomes analysis.

Main Results:

  • Failed thrombus aspiration occurred in 22.1% of patients.
  • Predictors of failure included older age, diabetes, hypertension, multi-vessel disease, high thrombus burden, and longer fluoroscopy time.
  • Failed aspiration was associated with significantly higher in-hospital mortality, no-reflow, cardiogenic shock, major adverse cardiovascular events, and increased one-year mortality and heart failure hospitalizations.

Conclusions:

  • Failed thrombus aspiration is a significant predictor of adverse short- and long-term outcomes in STEMI patients.
  • Identifying patients at higher risk for aspiration failure is crucial for optimizing procedural strategies and improving patient outcomes.

Keywords:
STEMIcardiovascular outcomesfailed aspirationprimary PCIthrombus aspiration

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