Feature | November 04, 2013

Removing Blood Clots During PCI Does Not Improve Outcomes

November 4, 2013 – According to a new study, aspirating blood clots does not significantly reduce microvascular obstruction or reduce the risk of death in patients with non-ST-elevation myocardial infarction (NSTEMI), when compared to standard percutaneous coronary intervention (PCI) without thrombectomy. Findings from the TATORT-NSTEMI clinical trial were presented at the 25th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium.

Thrombus aspiration, or the removal of blood clots, is frequently used for patients with ST-elevation myocardial infarction (STEMI, the most serious type of heart attack). However, there are no randomized data to unequivocally support thrombectomy in patients with NSTEMI. TATORT-NSTEMI is a prospective, controlled, multicenter, randomized trial that compared adjunctive thrombectomy to conventional PCI in patients with thrombus containing lesions.

The trial randomized 460 patients in a 1:1 fashion to thrombectomy and standard PCI. The primary endpoint was the extent of microvascular obstruction assessed by cardiac magnetic resonance (CMR) within four days after randomization and measured by the percentage of the left ventricle (LV). Clinical endpoints including death, myocardial reinfarction, target vessel revascularization and new congestive heart failure were analyzed at six months.

Microvascular obstruction was not different between the thrombectomy and standard PCI groups (1.7 percent LV vs. 1.6 percent LV, respectively, p=0.65).

Similarly, no significant differences were observed in infarct size, myocardial salvage index, or angiographic parameters such as blush grade or TIMI flow grade.

Clinical follow up at six months also revealed no differences in the combined clinical endpoint between the thrombectomy and the standard PCI group (p=0.85).

“TATORT-NSTEMI is the first randomized trial in NSTEMI testing the efficacy of additional manual aspiration thrombectomy,” said lead investigator Holger Thiele, M.D. Thiele is Deputy Director of the University of Leipzig Heart Center in Leipzig, Germany.

“Aspiration thrombectomy in patients with NSTEMI undergoing early PCI in thrombus containing lesions does not reduce the extent of no-reflow in comparison to standard PCI without thrombectomy.”

The TATORT-NSTEMI trial was funded by unrestricted grants from Terumo Europe and Lilly Germany. Thiele reported research funding from Terumo Europe, Lilly Germany, Maquet Cardiovascular and Teleflex Medical.

For more information: www.crf.org and www.tctconference.com

Related Content

medical imaging, low-dose radiation, cancer, LNT model study
News | Radiation Dose Management| February 04, 2016
The widespread belief that radiation from X rays, CT scans and other medical imaging can cause cancer is based on an...
caffeine consumption, extra heartbeats, UCSF study, UC San Francisco, Journal of the American Heart Association
News | EP Lab| February 04, 2016
Contrary to current clinical belief, regular caffeine consumption does not lead to extra heartbeats, which, while...
sleep apnea, heart failure readmissions, Thomas Jefferson University study
News | Heart Failure| February 04, 2016
Early diagnosis and treatment of sleep apnea may reduce six-month readmissions for patients hospitalized with heart...
Stereotaxis, Philips, collaboration, Niobe ES remote magnetic navigation system, Allura Xper FD10 cardiovascular X-ray

Niobe ES image courtesy of Stereotaxis Inc.

Technology | Cath Lab| February 04, 2016
February 4, 2016 — Stereotaxis and Philips have signed an addendum pursuant to their existing Development and Coopera
News | Heart Failure| February 04, 2016
New research from scientists at Sanford Burnham Prebys Medical Discovery Institute (SBP) published in the journal...
medtronic corevalve, tavr
News | February 03, 2016 | Dave Fornell
Medtronic announced Feb. 3 that the U.S.
Medtronic, CE Mark, Resolute Onyx DES, drug-eluting stent, expanded sizes and indications
News | Stents Drug Eluting| February 02, 2016
Medtronic plc announced the recent CE Mark and commercial launch for an expanded size matrix of the Resolute Onyx DES,...
Allegheny General Hospital, MRI, patients with implantable cardiac devices, safety and effectiveness
News | EP Lab| February 01, 2016
The findings of a major study led by cardiovascular imaging specialists at Allegheny General Hospital (AGH) suggest...
News | EP Lab| January 29, 2016
Diseased hearts may be thrown out of rhythm by structural differences, now visible for the first time, in protein...
TOBA-BTK study, six-month results, LINC 2016, Tack Endovascular System
News | Peripheral Arterial Disease (PAD)| January 29, 2016
Intact Vascular Inc. announced that positive six-month results from its Tack Optimized Balloon Angioplasty – Below-the-...
Overlay Init