Should the practicing interventionalist use manual aspiration systematically in all patients or only in selected patients with an angiographically obvious thrombotic burden?

Nicholas D Gollop, Philip J Murray

Research output: Contribution to journalArticle

Abstract

A best-evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was, should the practicing interventionalist use manual aspiration systematically in all patients undergoing percutaneous coronary intervention (PCI) or only in selected patients with an angiographically obvious thrombotic burden? Altogether, 198 papers were found using the reported search, of which nine represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that the evidence demonstrates that clinical and angiographic outcomes with respect to manual thrombectomy are similar and encouraging for patients with both angiographic evidence of thrombus burden and those in whom it is used routinely. In addition, there is no significant increase in major adverse cardiac events when routine use of manual aspiration is adopted as opposed to reserving its use for those patients with angiographic evidence of thrombus. In summary, the evidence supports the use of routine systematic manual aspiration in all patients undergoing primary PCI for ST-elevation myocardial infarction.
Original languageEnglish
Pages (from-to)731-735
Number of pages5
JournalInteractive Cardiovascular and Thoracic Surgery
Volume17
Issue number4
Early online date3 Jul 2013
DOIs
Publication statusPublished - Oct 2013

Keywords

  • Benchmarking
  • Coronary Angiography
  • Coronary Thrombosis
  • Evidence-Based Medicine
  • Humans
  • Myocardial Infarction
  • Patient Selection
  • Percutaneous Coronary Intervention
  • Predictive Value of Tests
  • Severity of Illness Index
  • Suction
  • Thrombectomy
  • Treatment Outcome
  • Manual aspiration
  • Angiographically thrombotic burden
  • Cardiology
  • Heart diseases
  • Review

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