AimsPrimary percutaneous coronary intervention (PPCI) with thrombectomy (TB) seems to reduce the thrombus burden, resulting in a larger flow area as measured with optical frequency domain imaging (OFDI).Methods and resultsIn a multi-centre study, 141 patients with ST elevation myocardial infarction <12 h from onset were randomized to either PPCI with TB using an Eliminate catheter (TB: n = 71) or without TB (non-TB: n = 70), having operators blinded for the OFDI results. The primary endpoint was minimum flow area (MinFA) post-procedure assessed by OFDI, defined as: [stent area + incomplete stent apposition (ISA) area] - (intraluminal defect + tissue prolapse area). Sample size was based on the expected difference of 0.72 mm2 in MinFA. Baseline demographics, pre-procedural quantitative coronary angiography (QCA), and procedural characteristics were well matched between the two groups. On OFDI, the stent area (TB: 7.62 ± 2.23 mm2, non-TB: 7.05 ± 2.12 mm 2, P = 0.14) and MinFA (TB: 7.08 ± 2.14 mm2 vs. non-TB: 6.51 ± 1.99 mm2, Δ0.57 mm2, P = 0.12) were not different. In addition, the amount of protrusion, intraluminal defect, and ISA area were similar in the both groups.ConclusionPPCI with TB was associated with a similar flow area as well as stent area to PPCI without TB.

Optical coherence tomography, ST elevation myocardial infarction, Thrombectomy,
European Heart Journal
Department of Cardiology

Onuma, Y, Thuesen, L, van Geuns, R.J.M, van der Ent, M, Desch, S, Fajadet, J, … Serruys, P.W.J.C. (2013). Randomized study to assess the effect of thrombus aspiration on flow area in patients with ST-elevation myocardial infarction: An optical frequency domain imaging study - TROFI trial. European Heart Journal, 34(14). doi:10.1093/eurheartj/ehs456