054 Predictors of failure of EXPORT ® thrombectomy in patients with myocardial infarction treated by percutaneous coronary intervention with an aspiration device: data from the RICO Survey

Thrombus aspiration is applicable in a large majority of patients with ST-segment elevation myocardial infarction (STEMI), and it results in better reperfusion and clinical outcomes than conventional PCI. However, some aspiration procedures remain none productive. Then, the aim of the present study was to determine the baseline clinical and/or angiographic characteristics of a none effective thrombectomy. Consecutive patients who benefited from thrombus aspiration and primary or rescue angioplasty, were included. The end point was effective or none effective aspiration defined by the presence of atherothrombotic material in the aspirate samples. Among the 180 patients included, material was collected in 155 patients (86%). The baseline characteristics are presented in table 1.Table 1. Baseline characteristicsThrombectomyNot effectiveEffectivepMen (%)80%69%NSAge (years, mean ± SD)70 ± 1562 ± 14< 0.05Heart Rate (mean ± SD)81 ± 2374 ± 21NSSystolic Blood pressure (mm Hg, mean ± SD)150 ± 32134 ± 27<0.005Delay symptoms-reperfusion (min, mean ± SD)504 ± 572641 ± 1064NSCulprit lesion (%)Left anterior artery48%35%NSCircumflex artery8%9%NSRight artery36%52%NSAHA classificationAHA A0%3%NSAHA B124%27%NSAHA B276%70%NSAHA C0%1%NSVisible thrombus (%)28%61%0.005Length (mm)< 10 mm0%3%NS10 – 20 mm48%47%NS> 10 mm52%50%NCalcification (%)60%37%0.048 Table 1. Baseline characteristics In multivariate analysis, the ability to remove the clot is negatively influenced by: a) age>70 years [OR(95%CI): 5.459 (1.943–15.339); p = 0.001 b) admission systolic blood pressure [OR(95%CI): 1.028 (1.010–1.048); p = 0.003] and c) no thrombus seen on the angiography [OR(95%CI): 0.220 (0.074–0.651), p = 0.006] The present study demonstrated that manual thrombus aspiration is effective in a majority but not in all the patients. Others studies are then needed to develop more efficient aspiration techniques and other aspiration devices to improve the results of such procedures.