SPC365

Manual thrombus aspiration - 12-year single centre experience

Session: Sessão de Posters 35 - Enfarte agudo do miocárdio com supra ST
Speaker: António Maria Rocha de Almeida

Congress: CPC 2024
Topic: E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme: 13. Acute Coronary Syndromes
Subtheme: 13.4 Acute Coronary Syndromes – Treatment
Session Type: Cartazes
FP Number: ---
Authors: António Maria Rocha De Almeida; Miguel Carias de Sousa; David Neves; Marta Paralta Figueiredo; Rafael Viana; Kisa Congo; Diogo Brás; Renato Fernandes; Angela Bento; Manuel Trinca; Lino Patricio

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Background</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Manual thrombus aspiration (TA) is not routinely recommended, due to the risk of stroke, as supported by some dedicated clinical trials. It is, however, a simple and delicate technique that gives the opportunity to improve angioplasty results by decreasing thrombus burden and potentially improving stent apposition and decreasing no-reflow phenomenon.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Purpose</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">To describe a single-centre experience on TA regarding clinical context, anatomic and technical features, procedure success and in-hospital occurrence of stroke.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Methods</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Retrospective study of procedures in which TA was performed from 2009 to 2021. Procedure and patient characteristics were analyzed and related with hospital records of new stroke diagnosis.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Results</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">TA was performed on 1136 procedures, in 1111 patients (77% male). As expected, most cases were acute coronary syndromes: STEMI (1031 cases; 90,8%) and NSTEMI (78; 6,9%). The device used was predominantly 6F (81,7%). Most frequent reference diameters were 3,0mm (529; 46,6%) and 3,5mm (244; 21,5%). The vessel was initially completely occluded in about two thirds of the cases (747; 65,8%) and the left anterior descending artery was the most frequent culprit (541; 47,7%), followed by the right coronary (386; 33,9%). Revascularization was considered completely successful in 1017 (89,5%) of cases. There were no cases of new stroke diagnosis during admission in these patients.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Conclusions</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">TA should not be routinely performed, as recommended by international guidelines. However, fear of stroke should not hamper its use whenever the benefits seem clear, such as the presence of a flow-limiting thrombus in a culprit artery, with a retrievable size and good catheter engagement of the coronary artery. In this relatively large sample, we report a good single centre experience with this technique, with no clinical stroke occurrence during admission.</span></span></span></span></p>