الفهرس 
Chapter 1 Acute Coronary SyndromeOnly 14 pages are availabe for public view
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Abstract
Primary PCI reduces cardiac mortality in acute myocardial infarction and is currently the preferred treatment & the default strategy. Several studies have shown that manual aspiration of the thrombus during primary PCI can prevent distal embolization, improve myocardial reperfusion and improve clinical outcome. There is a controversy in many clinical trials for the use of the aspiration devices during primary percutaneous coronary intervention (PPCI) in patients presented with acute ST segment elevation myocardial infarction (STEMI).
The purpose of the current study was to determine the efficacy of thrombus extraction as adjunctive treatment before angioplasty for STEMI patients , with evidence of heavy thrombus burden , regarding MACE (primary end-points ) & secondary end-points (TIMI flow ,MBG , ST-segment resolution , LV systolic function )as well as to determine 1 month follow-up results.
Two hundred and nine patients were enrolled in the current study with diagnosis of acute STEMI , and planned for primary PCI & with evidence of heavy thrombus burden. Primary PCI with aspiration thrombectomy was done for 73 patients and conventional primary PCI (without aspiration thrombectomy) was done for 136 patients.
The included patients were subjected to clinical evaluation by full history taking, clinical examination, laboratory investigations including cardiac enzymes, 12 leads surface electrocardiography, transthoracic echocardiography and PPCI.
The current study concluded that a strategy of manual aspiration thrombectomy in patients with STEMI with heavy thrombus aspiration ,had reduce index hospitalization mortality & as well as 1 month MACE rates , together with improvements regarding TIMI flow ,MBG , ST-segment resolution , LV systolic function , as compared with a strategy of PCI alone. Also, the need for revascularization was significantly lower with thrombus aspiration usage.
The current study recommends the use of thrombus aspiration when the thrombus burden is large and we emphasize the need to conduct large scale study with longer follow-up periods.