Myocardial blush is a predictor of mortality after primary angioplasty. Small studies showed a degree of improvement blush with manual thromboaspiration. The present work is a substudy of the TOTAL where thromboaspiration Export® catheter (Medtronic cardiovascular, Santa Rosa, CA) was assessed and compared to angioplasty without thromboaspiration. A total of 1610 patients were included, (791 for thromboaspiration and 819 angioplasty).
No significant differences between groups for Blush and final TIMI flow were observed. A reduced amount of distal embolization was observed in the thromboaspiration group. In the multivariate analysis, the myocardial final blush was associated with mortality (HR = 2.23, IC = 0.94-5.3).
Conclusion
The routine thromboaspiration do not lead to an improvement of the myocardial blush or final TIMI flow in primary angioplasty but decreased distal embolization. In the multivariate analysis distal embolization as does the blush were associated with higher mortality; the first parameter was less subjective than the blush.
CB Overgaard
2015-05-20
Original title: Angiographic Sub-study of the TOTAL trial: a randomized trial of manual thrombectomy during PCI for STEMI.
