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Adjunctive Devices for Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention

Slide: 28 of 39

Adjunctive Mechanical Thrombectomy Devices Versus PCI Alone in Mixed ACS Patients: All Outcomes and Adverse Events

In RCTs, the use of mechanical thrombectomy devices did not impact the risk of 30-day mortality (one trial), 30-day target revascularization (one trial), or 30-day MACE (one trial). In an controlled observational study, the use of a mechanical thrombectomy device has no impact on the risk of 180-day mortality, MI, target revascularization, or MACE. No trials or studies evaluated stroke or other aforementioned final health outcomes at other time points versus a control.

In RCTs, the use of mechanical thrombectomy devices significantly increased the risk of resolving ST-segment elevation (one trial) and had no impact on attaining TIMI-3 blood flow (one trial) versus a control. Given the risk difference for ST-segment resolution [RD 0.30 (0.03, 0.54), (CER 0.52)], three people would need to be treated with a mechanical thrombectomy device in order to have one person experience ST-segment resolution. In an controlled observational study, the use of a mechanical thrombectomy device was associated with a significantly lower rate of TIMI-3 blood flow versus a control. No trials or studies evaluated ejection fraction, MBG-3, distal embolization, or no reflow.

No trials or studies evaluating patients with NSTEMI or UA undergoing PCI and comparing mechanical thrombectomy versus a control on adverse events were identified.