This review summarizes current knowledge on manual thrombus aspiration during primary percutaneous coronary intervention for STEMI, noting that while routine use is not supported, selective use remains an option.
Does manual thrombus aspiration improve outcomes in patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention?
Routine manual thrombus aspiration is not supported by recent evidence for STEMI patients, but selective use based on thrombus burden remains a therapeutic option.
The role of manual thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) for acute ST-segment-elevation myocardial infarction has been a matter of intense research and debate now. Although recent randomized controlled clinical trials (notably TASTE Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia and TOTAL Trial of Routine Aspiration Thrombectomy With PCI Versus PCI Alone in Patients With STEMI) do not supply evidence supporting the routine use of TA in patients with ST-segment-elevation myocardial infarction, manual TA remains a therapeutic option for interventional cardiologists when treating patients with substantial thrombus burden during PPCI. It remains unknown whether patients might actually benefit from TA applied in a more selective manner depending on the thrombus burden during PPCI, instead of routine application. In this review, we summarize current knowledge on the instruments used in the TA procedure, positive as well as negative clinical effects of TA during PPCI, and analyze the potential reasons for observed effects, in an effort to help the clinical decision making by physicians for the use of TA in individual ST-segment-elevation myocardial infarction patients during PPCI.
Ge et al. (Sun,) conducted a review in ST-segment-elevation myocardial infarction. Manual thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) was evaluated. This review summarizes current knowledge on manual thrombus aspiration during primary percutaneous coronary intervention for STEMI, noting that while routine use is not supported, selective use remains an option.
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