Comparison of manual thrombus aspiration with direct stenting in patients with ST-segment elevation myocardial infarction and totally occluded culprit arteries

The aim of this study was to evaluate the efficacy and safety of the manual thrombus aspiration in comparison with direct stenting in patients with ST-segment elevation myocardial infarction (STEMI) and totally occluded culprit arteries.Material and Methods. Data were collected from the hospital database, which contained information about 1297 patients with STEMI who were admitted to the coronary care unit and underwent primary percutaneous coronary interventions. A total of 227 patients with totally occluded culprit arteries and partially or completely restored blood flow after wiring were included in the analysis. Altogether 25 patients after manual thrombus aspiration were compared with 202 patients after direct stenting. The groups were comparable by gender and age, and by the main clinical and angiographic characteristics.Results. There were no differences in in-hospital outcomes. In the thrombus aspiration group, the rate of no-reflow phenomenon was higher insignificantly (8 vs 3.5%, р=0.259). There were no incidences of death and major adverse cardiac events in the thrombus aspiration group. No cases of stent thrombosis were registered in either of group.Conclusion. The manual thrombus aspiration strategy in comparison with direct stenting in patients with STEMI and totally occluded culprit artery was not associated with improved clinical and procedural in-hospital outcomes.