Adjunctive Devices for Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention
Adjunctive Catheter Aspiration Thrombectomy Versus PCI Alone in Patients With Mixed ACS: All Outcomes
In one RCT, the use of catheter aspiration devices did not significantly impact the risk of in-hospital mortality. In a controlled observational study, the use of a catheter aspiration device significantly reduced the risk of 30-day mortality when compared with a control. No trials or studies evaluated MI, stroke, target revascularization, or MACE at any time period or mortality at additional time periods versus control.
In the same RCT, the use of catheter aspiration devices did not significantly impact the risk of attaining TIMI-3 blood flow, but the use of a catheter aspiration device significantly increased the risk of attaining an MBG of 3. Given the risk difference for MBG-3 [RD 0.30 (0.10, 0.51), (CER 0.09)], three people would need to be treated with a catheter aspiration device to cause one person to achieve an MBG of 3.
No trials or studies included in the CER evaluated ST-segment elevation, ejection fraction, distal embolization, or no reflow.
- Kunii H, Kijima M, Araki T, et al. Lack of efficacy of intracoronary thrombus aspiration before coronary stenting in patients with acute myocardial infarction: a multicenter randomized trial. J Am Coll Cardiol 2004;43:245A-6A.
- Sobieraj DM, White CM, Kluger J, et al. Adjunctive Devices for Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention. Comparative Effectiveness Review No. 42 (Prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center under Contract No. 290-2007-10067-I). Rockville, MD: Agency for Healthcare Research and Quality; December 2011. AHRQ Publication No. 11(12)-EHC089-EF. Available at www.effectivehealthcare.ahrq.gov/thrombusacs.cfm.
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