Routine Thrombus Aspiration: Another Negative Trial

Thrombus aspiration before percutaneous coronary intervention showed no mortality advantage over PCI alone at 30 days in patients with ST-segment-elevation MI.

Thrombus aspiration before primary percutaneous coronary intervention (PCI) for ST-segment-elevation myocardial infarction (STEMI) has intuitive appeal. That has prompted several randomized trials of the approach, most of them small and with conflicting results. Now, in a large registry-based trial, 7244 patients (about 60% of the STEMI patients at all 29 centers in Sweden, plus one center each in Denmark and Iceland) were randomized to undergo pre-PCI manual thrombus aspiration or PCI alone.

All-cause mortality at 30 days, the primary endpoint, was similar in the two groups: 2.8% for thrombus aspiration and 3.0% for PCI alone (hazard ratio, 0.94; 95% confidence interval, 0.72–1.22; P=0.63). This difference remained nonsignificant after acco…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)