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Coronary artery thrombus aspiration

A simple, rapid, relatively inexpensive adjunct to percutaneous coronary intervention.

The procedure may improve blood flow and resolution of ST-segment elevation.

The Thrombus Aspiration during Percutaneous Coronary Intervention in Acute Myocardial Infarction Study (TAPAS) involving 1071 patients suggested a survival benefit with thrombus aspiration among patients with STEMI.

In a multi center prospective, randomized, controlled, open label trial of 7244 patients with STEMI undergoing PCI were randomly assigned to manual thrombus aspiration followed by PCI or to PCI only: the primary endpoint was all cause mortality at 30 days and routine thrombus aspiration did not reduce 30 day mortality among patients with STEMI (Fröbert O et al).

Thrombus aspiration from coronary artery’s before PCI produces a thrombus burden and improves ST-segment resolution and coronary flow in patients with STEMI.

Randomized controlled studies of thrombus aspiration before PCI in patients with STEMI does not reduce the rate of death from any cause, or the composite of death for any cause, rehospitalization for myocardial infarction, or stent thrombosis at one year (Lagerqvist B et al).

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