Background: The clinical efficacy of thrombectomy in ST segment myocardial infarction (STEMI) remains controversial. Methods: The literature was searched by formal searches of electronic databases (MEDLINE, Pubmed). Trials that randomized STEMI patients to thrombectomy prior to primary percutaneous coronary intervention (PPCI) or conventional PPCI alone were included. Results: Manual thrombectomy vs. conventional PPCI (15 trials, n=10,535): Manual thrombectomy significantly decreased MACE [Odds ratio (OR) 0.77; 95% confidence interval (CI) 0.66-0.89; I2=0%], myocardial infarction (OR 0.64, 95% CI 0.45 to 0.92; I2=0%) and target vessel revascularization (OR 0.78, 95% CI 0.63 to 0.96; I2=0%) in comparison with conventional PPCI. Beneficial trends were noted for mortality (OR 0.83, 95% CI 0.67 to 1.01; I2=0%). Mechanical thrombectomy vs. conventional PPCI (8 trials, n=1,833): There was no difference between the thrombectomy and conventional PPCI in the risk of MACE (OR 0.85; 95% CI 0.60 to 1.21; I2=66.7%), mortality (OR 1.08; 95% CI 0.64 to 1.81; I2=46.8%), myocardial infarction (OR 0.57; 95% CI 0.22 to 1.46; I2=0%), target vessel revascularization (OR 0.74; 95% CI 0.45 to 1.20; I2=14.3%). Conclusions: Manual thrombectomy undergoing PPCI is beneficial in reducing MACE, myocardial infarction and target vessel revascularization except mortality compared with conventional PPCI alone, however, no benefit was observed in mechanical thrombectomy. (Figure Presented).
Yan, Q., Jihong, W., Nie, S.-P., Xin, D., Yin, Z., Changqi, J., & Changsheng, M. (2014). UPDATED META-ANALYSIS OF PROSPECTIVE RANDOMIZED CONTROLLED TRIALS EVALUATING ADJUNCTIVE THROMBECTOMY IN PRIMARY PERCUTANEOUS CORONARY INTERVENTION FOR ST-ELEVATION MYOCARDIAL INFARCTION. Journal of the American College of Cardiology, 63(12), A1839. https://doi.org/10.1016/s0735-1097(14)61842-8