Cardiovascular Intervention and Therapeutics

, Volume 30, Issue 1, pp 22–28

Clinical impact of thrombus aspiration during primary percutaneous coronary intervention in acute myocardial infarction with occluded culprit

Authors

    • Department of CardiologyKyoto First Red Cross Hospital
  • Yoshio Kohno
    • Department of CardiologyKyoto First Red Cross Hospital
  • Takeshi Nakamura
    • Department of Cardiovascular MedicineKyoto Prefectural University School of Medicine
  • Takashi Yanagiuchi
    • Department of CardiologyKyoto First Red Cross Hospital
  • Sho Hashimoto
    • Department of CardiologyKyoto First Red Cross Hospital
  • Daisuke Ito
    • Department of CardiologyKyoto First Red Cross Hospital
  • Masayoshi Kimura
    • Department of CardiologyKyoto First Red Cross Hospital
  • Akihiro Matsui
    • Department of CardiologyKyoto First Red Cross Hospital
  • Hirokazu Yokoi
    • Department of CardiologyKyoto First Red Cross Hospital
  • Masayasu Arihara
    • Department of Emergency MedicineKyoto First Red Cross Hospital
  • Masayuki Hyogo
    • Department of CardiologyKyoto First Red Cross Hospital
  • Takatomo Shima
    • Department of CardiologyKyoto First Red Cross Hospital
  • Takahisa Sawada
    • Department of CardiologyKyoto First Red Cross Hospital
  • Satoaki Matoba
    • Department of Cardiovascular MedicineKyoto Prefectural University School of Medicine
  • Hiroyuki Yamada
    • Department of Cardiovascular MedicineKyoto Prefectural University School of Medicine
  • Akiyoshi Matsumuro
    • Department of Cardiovascular MedicineKyoto Prefectural University School of Medicine
  • Takeshi Shirayama
    • Department of Cardiovascular MedicineKyoto Prefectural University School of Medicine
  • Makoto Kitamura
    • Department of CardiologyKyoto Second Red Cross Hospital
  • Keizo Furukawa
    • Department of CardiologyTanabe Central Hospital
Original Article

DOI: 10.1007/s12928-014-0282-4

Cite this article as:
Shiraishi, J., Kohno, Y., Nakamura, T. et al. Cardiovasc Interv and Ther (2015) 30: 22. doi:10.1007/s12928-014-0282-4

Abstract

Data regarding clinical efficacy of thrombectomy in patients with acute myocardial infarction (AMI) have been still limited in Japan. Using the AMI-Kyoto Multi-Center Risk Study database, the clinical background characteristics, angiographic findings, primary percutaneous coronary intervention (PCI) results and in-hospital prognoses were retrospectively compared between AMI patients with totally occluded infarct-related artery (IRA) (TIMI flow grade 0) undergoing thrombus aspiration during primary PCI (with-aspiration patients, n = 568) and those without thrombus aspiration (without-aspiration patients, n = 266). The with-aspiration patients were more likely to have higher TIMI grade in the IRA immediately after primary PCI, and had a lower in-hospital mortality rate than the without-aspiration patients. According to a multivariate analysis, thrombectomy as well as stent usage was found to be independent predictor of final TIMI flow grade ≥2 in the IRA, and the final TIMI flow grade ≥2 in the IRA was found to be an independent factor for in-hospital survival. These results suggest that among real-world, unselected Japanese AMI patients with totally occluded IRA on initial coronary angiography, thrombus aspiration is an effective adjunctive therapy during primary PCI to improve final epicardial coronary flow in the IRA, which might lead to better in-hospital prognosis.

Keywords

Acute myocardial infarctionAspirationThrombectomy

Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2014