Why the study?
Standard monorail coronary aspiration devices are often ineffective for large thrombi in STEMI, while guide extension catheters pose trackability issues and dissection risks.
Case Report (n=4)
The off-label use of neurointerventional aspiration catheters like the Sofia may offer a viable option for extracting refractory clots during primary PCI for STEMI.
May aid refractory thrombus extraction in STEMI PCI; hypothesis-generating and requires prospective validation before adoption.
Despite inconclusive and conflicting results of trials and meta-analyses assessing aspiration thrombectomy in ST-segment elevation myocardial infarction (STEMI), trends toward reduced mortality were observed in the high thrombus burden subgroup [1–3]. With a large thrombus being one of the strongest predictors of the no flow phenomenon, manual thromboaspiration remains an effective method of its prevention, especially in patients who cannot undergo a staged procedure after IIB/IIIA inhibitor administration because satisfactory reperfusion has not been achieved during the initial intervention [4–8]. Since standard monorail coronary aspiration devices are often ineffective in the case of a large thrombus, guide extension catheters have been used for clot extraction. Their bigger lumen comes at a cost of worse trackability and a higher risk of artery dissection [9].
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Klaudel et al. (2022) conducted a case report in Acute myocardial infarction with refractory or inaccessible clot (n=4). Sofia neurointerventional aspiration catheter was evaluated on Successful clot aspiration and restoration of TIMI 3 flow.
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