Stroke in the TOTAL trial: a randomized trial of routine thrombectomy vs. percutaneous coronary intervention alone in ST elevation myocardial infarction
Why the study?
Does routine manual thrombectomy increase the risk of stroke compared to PCI alone in patients with STEMI?
Population
10,732 patients with ST elevation myocardial infarction (STEMI)
Comparison
Routine manual thrombectomy during percutaneous… vs Percutaneous coronary intervention alone
Design
RCT, Randomized, Strokes adjudicated by neurologists blinded to treatment…
Follow-up
180 days
Authors
Discussion
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Member takes
Implication
Warrants avoiding routine thrombectomy in STEMI PCI; challenges prior adjunctive strategies and reinforces PCI alone.
Structured PICO
Does routine manual thrombectomy increase the risk of stroke compared to PCI alone in patients with STEMI?
P
Population
10,732 patients with ST elevation myocardial infarction (STEMI)
I
Intervention
Routine manual thrombectomy during percutaneous coronary intervention
C
Comparator
Percutaneous coronary intervention alone
O
Outcome
Stroke within 30 dayssafety
Routine manual thrombectomy during primary PCI for STEMI is associated with a significant increase in the risk of stroke, including disabling and fatal strokes, highlighting a critical safety concern.
Cite This Study
Jolly et al. (2015) studied this question.