Professor Serruys presented the results of the TROFI trial that compares the minimal intra-stent flow area in STEMI patients post primary PCI with or without manual thrombus aspiration.
The minimal intra-stent flow area helps assess thrombus burden and is defined as: (stent area + incomplete stent apposition area) – (intralulminal defect area attached to the wall + intraluminal defect area free from the wall + tissue prolapse area).
To measure the minimal flow area, researchers used a novel technology called ODFI (optical domain frequency imaging), an invasive tool that generates precise high resolution images (180 µ) capable of detecting and quantifying thrombi in stent lumen at implantation.
141 patients were randomized (1:1) to primary PCI with or without thrombectomy. After an optimal angiographic result, all patients were submitted to ODFI. The minimal flow area post stenting did not show significant variation (7,08±2,14 with thrombectomy vs. 6,51±1,99 without thrombectomy, P=0,12).
Conclusion: thrombectomy significantly reduced the impact of thrombus according to minimal flow area post-stenting. The use of this promising novel technology allows the assessment of intracoronary thrombi during PCI.