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

  • Jun Shiraishi
  • Yoshio Kohno
  • Takeshi Nakamura
  • Takashi Yanagiuchi
  • Sho Hashimoto
  • Daisuke Ito
  • Masayoshi Kimura
  • Akihiro Matsui
  • Hirokazu Yokoi
  • Masayasu Arihara
  • Masayuki Hyogo
  • Takatomo Shima
  • Takahisa Sawada
  • Satoaki Matoba
  • Hiroyuki Yamada
  • Akiyoshi Matsumuro
  • Takeshi Shirayama
  • Makoto Kitamura
  • Keizo Furukawa
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

Authors and Affiliations

  • Jun Shiraishi
    • 1
  • Yoshio Kohno
    • 1
  • Takeshi Nakamura
    • 3
  • Takashi Yanagiuchi
    • 1
  • Sho Hashimoto
    • 1
  • Daisuke Ito
    • 1
  • Masayoshi Kimura
    • 1
  • Akihiro Matsui
    • 1
  • Hirokazu Yokoi
    • 1
  • Masayasu Arihara
    • 2
  • Masayuki Hyogo
    • 1
  • Takatomo Shima
    • 1
  • Takahisa Sawada
    • 1
  • Satoaki Matoba
    • 3
  • Hiroyuki Yamada
    • 3
  • Akiyoshi Matsumuro
    • 3
  • Takeshi Shirayama
    • 3
  • Makoto Kitamura
    • 4
  • Keizo Furukawa
    • 5
  1. 1.Department of CardiologyKyoto First Red Cross HospitalKyotoJapan
  2. 2.Department of Emergency MedicineKyoto First Red Cross HospitalKyotoJapan
  3. 3.Department of Cardiovascular MedicineKyoto Prefectural University School of MedicineKyotoJapan
  4. 4.Department of CardiologyKyoto Second Red Cross HospitalKyotoJapan
  5. 5.Department of CardiologyTanabe Central HospitalKyotanabeJapan