AngioJet Rheolytic Thrombectomy In Patients With Thrombolysis In Myocardial Infarction Thrombus Grade 5: An Observational Study

OBJECTIVES The aim of this study was to evaluate the effectiveness and safety of AngioJet rheolytic thrombectomy among patients with high thrombus burden.BACKGROUND Routine manual thrombus aspiration in patients with ST-segment elevation myocardial infarction (STEMI) does not improve clinical outcomes and was associated with an increased rate of stroke. However, the safety of mechanical thrombus aspirationis still unknown.METHODS This was a single-center study involving 621 patients with Thrombolysis In Myocardial Infarction thrombus grade 5. The primary outcome was the composite of major adverse cardiovascular events (MACE)within 12 months. The safety outcome was stroke within 1-year. RESULTS AngioJet rheolytic thrombectomy was performed in 117 patients. After propensity-score matching, there was no significant difference both in the incidence of MACE(11.1% vs 17.9%, hazard ratio, 1.641; 95% confidence interval[CI], 0.822 to 3.277, p=.161) and the incidences of stroke (1.7% vs 2.6%, hazard ratio, 1.522; 95% confidence interval[CI], 0.254 to 9.107, p=.646)between two groups at 1-year follow-up.CONCLUSIONS In patients with Thrombolysis In Myocardial Infarction thrombus grade 5, AngioJet rheolytic thrombectomydid not improve clinical outcomesat 1 year. However, AngioJet rheolytic thrombectomy did not increase the risk of stroke in patients with high thrombus burden.