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A recent clinical trial conducted by researchers at the University of Leipzig, Germany revealed that the routine addition of aspiration thrombectomy before percutaneous coronary intervention (PCI) does not result in improved clinical outcomes for patients with non-ST-elevation myocardial infarction (NSTEMI). The details of this trial, which was entitled Thrombus Aspiration in Thrombus-Containing Culprit Lesions in NSTEMI, were published on November 19, 2015 in the medical journal, European Heart Journal: Acute Cardiovascular Care.
In this trial, researchers aimed to determine whether thrombectomy in patients with NSTEMI was justified, given the insufficient data in support of this recommendation. The study was conducted at eight high-volume clinics throughout Germany and included 440 participants who were high-risk NSTEMI patients with thrombus-associated lesions. Of these 440 patients, 221 received aspiration thrombectomy before PCI, and 219 did not.
They followed these patients for a 12-month period, at the end of which they found that a total of 11% (or 48 people) experienced adverse cardiac events. These included 8.7% of the patients who received thrombectomies and 13.4% of the patients who did not.
Based on these findings, the study’s authors concluded that, “taken together, aspiration thrombectomy as shown in our TATORT-NSTEMI trial does not add a benefit for the patient.” The senior author of the study, Dr. Holger Thiele of the University of Leipzig Heart Center, added, “The STEMI American Heart Association/American College of Cardiology guidelines already have a class 3 recommendation not to use thrombectomy on a routine basis. Currently, thrombectomy should only be used in bail-out situations according to STEMI guidelines.”
You can read more about this trial at Medscape.
