Thrombus aspiration followed by direct stenting

A novel strategy of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Results of the Polish-Italian-Hungarian RAndomized ThrombEctomy Trial (PIHRATE Trial)

Dariusz Dudek, Waldemar Mielecki, Francesco Burzotta, Mariusz Gasior, Adam Witkowski, I. Horváth, Jacek Legutko, Andrzej Ochala, Paolo Rubartelli, Roman M. Wojdyla, Zbigniew Siudak, Piotr Buchta, Jerzy Pregowski, D. Aradi, Andrzej MacHnik, Michal Hawranek, Tomasz Rakowski, Artur Dziewierz, Krzysztof Zmudka

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Background: Previous studies with thrombectomy showed different results, mainly due to use of thrombectomy as an additional device not instead of balloon predilatation. The aim of the present study was to assess impact of aspiration thrombectomy followed by direct stenting. Methods: Patients with ST elevation myocardial infarction (STEMI) 70% (STR > 70%) 60 minutes after primary angioplasty (percutaneous coronary intervention [PCI]). Secondary end points included angiographic myocardial blush grade (MBG) after PCI, combination of STR > 70% immediately after PCI and MBG grade 3 (optimal myocardial reperfusion), Thrombolysis In Myocardial Infarction flow after PCI, angiographic complications, and in-hospital major adverse cardiac events. Results: Aspiration thrombectomy success rate was 91% (crossing of the lesion with thrombus reduction and flow restoration). There was no significant difference in STR ≥ 70% after 60 minutes (53.7% vs 35.1%, P = .29). STR > 70% immediately after PCI (41% vs 26%, P <.05), MBG grade 3 (76% vs 58%, P <.03), and optimal myocardial reperfusion (35.1% vs 11.8%, P <.001) were more frequent in TS. There was no difference in between the groups in 6-month mortality (4% vs 3.1%, P = .74) and reinfarction rate (1% vs 3.1%, P = .29). Conclusions: Aspiration thrombectomy and direct stenting is safe and effective in STEMI patients with early presentation (

Original languageEnglish
Pages (from-to)966-972
Number of pages7
JournalAmerican Heart Journal
Volume160
Issue number5
DOIs
Publication statusPublished - Nov 2010

Fingerprint

Thrombectomy
Percutaneous Coronary Intervention
Thrombosis
Myocardial Reperfusion
Angioplasty
Myocardial Infarction
ST Elevation Myocardial Infarction
Equipment and Supplies
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Thrombus aspiration followed by direct stenting : A novel strategy of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Results of the Polish-Italian-Hungarian RAndomized ThrombEctomy Trial (PIHRATE Trial). / Dudek, Dariusz; Mielecki, Waldemar; Burzotta, Francesco; Gasior, Mariusz; Witkowski, Adam; Horváth, I.; Legutko, Jacek; Ochala, Andrzej; Rubartelli, Paolo; Wojdyla, Roman M.; Siudak, Zbigniew; Buchta, Piotr; Pregowski, Jerzy; Aradi, D.; MacHnik, Andrzej; Hawranek, Michal; Rakowski, Tomasz; Dziewierz, Artur; Zmudka, Krzysztof.

In: American Heart Journal, Vol. 160, No. 5, 11.2010, p. 966-972.

Research output: Contribution to journalArticle

Dudek, D, Mielecki, W, Burzotta, F, Gasior, M, Witkowski, A, Horváth, I, Legutko, J, Ochala, A, Rubartelli, P, Wojdyla, RM, Siudak, Z, Buchta, P, Pregowski, J, Aradi, D, MacHnik, A, Hawranek, M, Rakowski, T, Dziewierz, A & Zmudka, K 2010, 'Thrombus aspiration followed by direct stenting: A novel strategy of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Results of the Polish-Italian-Hungarian RAndomized ThrombEctomy Trial (PIHRATE Trial)', American Heart Journal, vol. 160, no. 5, pp. 966-972. https://doi.org/10.1016/j.ahj.2010.07.024
Dudek, Dariusz ; Mielecki, Waldemar ; Burzotta, Francesco ; Gasior, Mariusz ; Witkowski, Adam ; Horváth, I. ; Legutko, Jacek ; Ochala, Andrzej ; Rubartelli, Paolo ; Wojdyla, Roman M. ; Siudak, Zbigniew ; Buchta, Piotr ; Pregowski, Jerzy ; Aradi, D. ; MacHnik, Andrzej ; Hawranek, Michal ; Rakowski, Tomasz ; Dziewierz, Artur ; Zmudka, Krzysztof. / Thrombus aspiration followed by direct stenting : A novel strategy of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Results of the Polish-Italian-Hungarian RAndomized ThrombEctomy Trial (PIHRATE Trial). In: American Heart Journal. 2010 ; Vol. 160, No. 5. pp. 966-972.
@article{d38b2cd74730497ca10a668eed953e0f,
title = "Thrombus aspiration followed by direct stenting: A novel strategy of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Results of the Polish-Italian-Hungarian RAndomized ThrombEctomy Trial (PIHRATE Trial)",
abstract = "Background: Previous studies with thrombectomy showed different results, mainly due to use of thrombectomy as an additional device not instead of balloon predilatation. The aim of the present study was to assess impact of aspiration thrombectomy followed by direct stenting. Methods: Patients with ST elevation myocardial infarction (STEMI) 70{\%} (STR > 70{\%}) 60 minutes after primary angioplasty (percutaneous coronary intervention [PCI]). Secondary end points included angiographic myocardial blush grade (MBG) after PCI, combination of STR > 70{\%} immediately after PCI and MBG grade 3 (optimal myocardial reperfusion), Thrombolysis In Myocardial Infarction flow after PCI, angiographic complications, and in-hospital major adverse cardiac events. Results: Aspiration thrombectomy success rate was 91{\%} (crossing of the lesion with thrombus reduction and flow restoration). There was no significant difference in STR ≥ 70{\%} after 60 minutes (53.7{\%} vs 35.1{\%}, P = .29). STR > 70{\%} immediately after PCI (41{\%} vs 26{\%}, P <.05), MBG grade 3 (76{\%} vs 58{\%}, P <.03), and optimal myocardial reperfusion (35.1{\%} vs 11.8{\%}, P <.001) were more frequent in TS. There was no difference in between the groups in 6-month mortality (4{\%} vs 3.1{\%}, P = .74) and reinfarction rate (1{\%} vs 3.1{\%}, P = .29). Conclusions: Aspiration thrombectomy and direct stenting is safe and effective in STEMI patients with early presentation (",
author = "Dariusz Dudek and Waldemar Mielecki and Francesco Burzotta and Mariusz Gasior and Adam Witkowski and I. Horv{\'a}th and Jacek Legutko and Andrzej Ochala and Paolo Rubartelli and Wojdyla, {Roman M.} and Zbigniew Siudak and Piotr Buchta and Jerzy Pregowski and D. Aradi and Andrzej MacHnik and Michal Hawranek and Tomasz Rakowski and Artur Dziewierz and Krzysztof Zmudka",
year = "2010",
month = "11",
doi = "10.1016/j.ahj.2010.07.024",
language = "English",
volume = "160",
pages = "966--972",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Thrombus aspiration followed by direct stenting

T2 - A novel strategy of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. Results of the Polish-Italian-Hungarian RAndomized ThrombEctomy Trial (PIHRATE Trial)

AU - Dudek, Dariusz

AU - Mielecki, Waldemar

AU - Burzotta, Francesco

AU - Gasior, Mariusz

AU - Witkowski, Adam

AU - Horváth, I.

AU - Legutko, Jacek

AU - Ochala, Andrzej

AU - Rubartelli, Paolo

AU - Wojdyla, Roman M.

AU - Siudak, Zbigniew

AU - Buchta, Piotr

AU - Pregowski, Jerzy

AU - Aradi, D.

AU - MacHnik, Andrzej

AU - Hawranek, Michal

AU - Rakowski, Tomasz

AU - Dziewierz, Artur

AU - Zmudka, Krzysztof

PY - 2010/11

Y1 - 2010/11

N2 - Background: Previous studies with thrombectomy showed different results, mainly due to use of thrombectomy as an additional device not instead of balloon predilatation. The aim of the present study was to assess impact of aspiration thrombectomy followed by direct stenting. Methods: Patients with ST elevation myocardial infarction (STEMI) 70% (STR > 70%) 60 minutes after primary angioplasty (percutaneous coronary intervention [PCI]). Secondary end points included angiographic myocardial blush grade (MBG) after PCI, combination of STR > 70% immediately after PCI and MBG grade 3 (optimal myocardial reperfusion), Thrombolysis In Myocardial Infarction flow after PCI, angiographic complications, and in-hospital major adverse cardiac events. Results: Aspiration thrombectomy success rate was 91% (crossing of the lesion with thrombus reduction and flow restoration). There was no significant difference in STR ≥ 70% after 60 minutes (53.7% vs 35.1%, P = .29). STR > 70% immediately after PCI (41% vs 26%, P <.05), MBG grade 3 (76% vs 58%, P <.03), and optimal myocardial reperfusion (35.1% vs 11.8%, P <.001) were more frequent in TS. There was no difference in between the groups in 6-month mortality (4% vs 3.1%, P = .74) and reinfarction rate (1% vs 3.1%, P = .29). Conclusions: Aspiration thrombectomy and direct stenting is safe and effective in STEMI patients with early presentation (

AB - Background: Previous studies with thrombectomy showed different results, mainly due to use of thrombectomy as an additional device not instead of balloon predilatation. The aim of the present study was to assess impact of aspiration thrombectomy followed by direct stenting. Methods: Patients with ST elevation myocardial infarction (STEMI) 70% (STR > 70%) 60 minutes after primary angioplasty (percutaneous coronary intervention [PCI]). Secondary end points included angiographic myocardial blush grade (MBG) after PCI, combination of STR > 70% immediately after PCI and MBG grade 3 (optimal myocardial reperfusion), Thrombolysis In Myocardial Infarction flow after PCI, angiographic complications, and in-hospital major adverse cardiac events. Results: Aspiration thrombectomy success rate was 91% (crossing of the lesion with thrombus reduction and flow restoration). There was no significant difference in STR ≥ 70% after 60 minutes (53.7% vs 35.1%, P = .29). STR > 70% immediately after PCI (41% vs 26%, P <.05), MBG grade 3 (76% vs 58%, P <.03), and optimal myocardial reperfusion (35.1% vs 11.8%, P <.001) were more frequent in TS. There was no difference in between the groups in 6-month mortality (4% vs 3.1%, P = .74) and reinfarction rate (1% vs 3.1%, P = .29). Conclusions: Aspiration thrombectomy and direct stenting is safe and effective in STEMI patients with early presentation (

UR - http://www.scopus.com/inward/record.url?scp=78649372985&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78649372985&partnerID=8YFLogxK

U2 - 10.1016/j.ahj.2010.07.024

DO - 10.1016/j.ahj.2010.07.024

M3 - Article

VL - 160

SP - 966

EP - 972

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 5

ER -