Should Aspiration Thrombectomy Be Performed in All, Most, or Few Primary PCI Procedures?

December 02, 2009

In This Article

Mechanical Thrombectomy Devices

The most widely used mechanical thrombectomy device has been rheolytic thrombectomy with the Possis AngioJet (Possis, Inc.), which was studied in the AngioJet Rheolytic Thrombectomy In Patients Undergoing Primary Angioplasty for Acute Myocardial Infarction (AiMI) trial.[2] Unfortunately, the use of AngioJet in the AiMI trial was associated with larger infarct size and an unexpected increase in mortality.

In a large meta-analysis, Drs. Bavry and Bhatt found that mechanical thrombectomy with AngioJet and other mechanical thrombectomy devices had no beneficial effect on myocardial perfusion (measured by electrocardiographic ST-segment resolution [STR] and angiographic myocardial blush grade [MBG]) and had an adverse effect on mortality (Slide 2).[3] Consequently, mechanical thrombectomy is now used infrequently with primary PCI.

Slide 2.

Impact of Thrombectomy and Distal Protection Devices on Mortality - Bavry Meta-Analysis


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