Thrombus Aspiration for ST-Segment–Elevation Myocardial Infarction in Modern Era
Still an Issue of Debate?
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- Commonly Used TA Devices
- Potential Efficacy and Clinical Evidence for Positive Effects of TA in PPCI
- Clinical Trials Not Showing Beneficial Effects of TA During PPCI
- Reasons Potentially Responsible for the Divergent Results of TA During PPCI
- Impact and Related Mechanisms of TA on Platelet Activation and Coagulation
- Potential Mechanisms of Increased Incidence of Stroke Related to TA
- Future Perspective
- Disclosures
- References
- Figures & Tables
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Abstract
The role of manual thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) for acute ST-segment–elevation myocardial infarction has been a matter of intense research and debate now. Although recent randomized controlled clinical trials (notably TASTE [Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia] and TOTAL [Trial of Routine Aspiration Thrombectomy With PCI Versus PCI Alone in Patients With STEMI]) do not supply evidence supporting the routine use of TA in patients with ST-segment–elevation myocardial infarction, manual TA remains a therapeutic option for interventional cardiologists when treating patients with substantial thrombus burden during PPCI. It remains unknown whether patients might actually benefit from TA applied in a more selective manner depending on the thrombus burden during PPCI, instead of routine application. In this review, we summarize current knowledge on the instruments used in the TA procedure, positive as well as negative clinical effects of TA during PPCI, and analyze the potential reasons for observed effects, in an effort to help the clinical decision making by physicians for the use of TA in individual ST-segment–elevation myocardial infarction patients during PPCI.
- © 2017 American Heart Association, Inc.
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This Issue
Jump to
- Article
- Abstract
- Commonly Used TA Devices
- Potential Efficacy and Clinical Evidence for Positive Effects of TA in PPCI
- Clinical Trials Not Showing Beneficial Effects of TA During PPCI
- Reasons Potentially Responsible for the Divergent Results of TA During PPCI
- Impact and Related Mechanisms of TA on Platelet Activation and Coagulation
- Potential Mechanisms of Increased Incidence of Stroke Related to TA
- Future Perspective
- Disclosures
- References
- Figures & Tables
- Info & Metrics
Article Tools
- Thrombus Aspiration for ST-Segment–Elevation Myocardial Infarction in Modern EraJunhua Ge, Andreas Schäfer, Georg Ertl and Peter NordbeckCirculation: Cardiovascular Interventions. 2017;10:e005739, originally published October 17, 2017https://doi.org/10.1161/CIRCINTERVENTIONS.117.005739
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