An international survey of clinical practice during primary percutaneous coronary intervention for ST-elevation myocardial infarction with a focus on aspiration thrombectomy

作者：Russo Juan J; Dzavik Vladimir; Cairns John A; Rao Sunil V; Niemela Kari O; Natarajan Madhu K; Bertrand Olivier F; Eskola Markku; Welsh Robert; Maciejewski Pawel; Cheema Asim N; Fung Anthony; Cantor Warren J; Lavi Shahar; Widimsky Petr; Jolly Sanjit S^*

来源：Eurointervention, 2013, 8(10): 1143-1148.

DOI：10.4244/EIJV8I10A177

• pharmacology
• primary angioplasty
• STEMI

Aims: Data suggest that there is a variable use of thrombectomy during primary percutaneous coronary interventions (PPCI). We sought to evaluate practices during PPCI for ST-elevation myocardial infarction (STEMI), including the use of aspiration thrombectomy, and to determine the feasibility of conducting a definitive aspiration thrombectomy trial. %26lt;br%26gt;Methods and results: A 27-item online survey was distributed to 1,607 interventional cardiologists internationally. A total of 461 responses were received. During PPCI, aspiration thrombectomy is used routinely by 36% of respondents, and selectively by 60%. Twenty-five percent of respondents reported experiencing a complication related to thrombectomy including: vessel dissection (13%), bringing thrombus back into left main coronary artery from target vessel (5%), stroke or transient ischaemic attack (2%), and coronary artery perforation (1%). The vast majority of respondents (89%) believe that a confirmatory aspiration thrombectomy trial is needed and 85% would be willing to randomise patients in such a trial. %26lt;br%26gt;Conclusions: The majority of interventional cardiologists surveyed are not using thrombectomy routinely during PPCI. The survey results suggest that a large, confirmatory thrombectomy trial is needed and feasible in the current era. The survey also highlights a significant level of variability and underutilisation of other evidence-based therapies during PPCI.

• 出版日期2013-2