Manual aspiration thrombectomy in acute ST elevation myocardial infarction: New gold standard

Table 1 One-year clinical outcomes in selected randomized ST segment myocardial infarction trials from 2000 to 2010

Study	Yr	Intervention	Control	n	All-cause death (%)		Cardiac mortality (%)		MI (%)
					C	S	C	S	C	S
NORDISTEMI[16]	2010	All PCI	Selective	276	3.0	2.2	NA	NA	9.0	3.0
HORIZONS AMI[17]	2009	Bivalurudin	Hep/Gp	3602	4.8	3.5	3.8	2.1	NA	NA
TAPAS[5]	2008	TA + PCI	PCI/no TA	1071	7.6	4.7	6.7	3.6	4.3	2.2
DANAMI-2[18]	2008	PCI	Lytic	1424	1.3	1.4	NA	NA	0.9	1.3
Transfer with Tirofiban for PCI	2007	Transfer/PCI	Lytic	401	NA	NA	12.5	7.0	7.5	3.5
Thrombolysis with STEMI[19]
SESAMI[20]	2007	DES	BMS	320	4.3	1.8	NA	NA	1.8	1.8
TYPHOON[21]	2006	DES	BMS	712	2.2	2.3	1.4	2.0	1.4	1.1
PASSION[22]	2006	DES	BMS	619	NA	NA	6.5	4.5	1.9	1.6
ADMIRAL[23]	2004	Abciximab + PCI	PCI	400	12.5	6.0	10.5	5.0	6.0	1.0
STENTIM-2[24]	2000	BMS	BA	211	1.9	3.0	NA	NA	5.5	4.0

BA: Balloon angioplasty; BMS: Bare metal stent; C: Control group; DES: Drug-eluting stent; Gp: Glycoprotein IIb/IIIa inhibitors; Hep: Heparin; MI: Myocardial infarction; NA: Not applicable; S: Study (intervention) group; TA: Thrombus aspiration; PCI: Percutaneous coronary interventio

Table 2 Randomized studies utilizing manual aspiration devices in ST segment myocardial infarction and primary percutaneous coronary intervention¹

Study	Yr	n	Device	Primary endpoint(s)	Outcomes1
EXPIRA[14]	2009	175	Export (Medtronic, Minneapolis, MN, USA)	MBG > 2, STR	Improvement
VAMPIRE[11]	2008	355	TVAC (Nipro, Osaka, JP)	SR or NR	Trend to improvement
TAPAS[5]	2008	1071	Export (Medtronic, Minneapolis, MN, USA)	MBG	Improvement
De Luca et al[8]	2006	76	Diver CE (Invatec, Brescia, IT)	MBG > 2, STR	Improvement
Kaltoft et al[9]	2006	215	Rescue (BSC, Maple Grove, MN, USA)	Myocardial salvage	No improvement
DEAR-MI[10]	2006	148	Pronto (Vascular Solutions, Minneapolis, MN, USA)	STR, MBG 3	Improvement
REMEDIA[6]	2005	99	Diver CE (Invatec, Brescia, IT)	MBG > 2, STR	Improvement

¹Please see text for study data. MBG: Myocardial blush grade; NR: No reflow; SR: Slow reflow; STR: ST segment resolution.