Coronary Clot Aspiration Safe Long Term

Thrombus aspiration as safe as stents long term but not beneficial

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) After certain types of heart attacks, doctors often use stents to prop open the arteries. Another method that may be used involves removing blood clots through thrombus aspiration (TA), but studies have shown mixed long-term results.

A new study has found TA  either through a manual aspirator or a disposable vacuum catheter designed to sheer and remove a blood clot to be safe long term.

"Talk to your cardiologist about options for treating clogged coronary arteries."

Maarten Vink, MD, from the department of cardiology at Onze Lieve Vrouwe Gasthuis, translated as The Our Lady Hospital, in The Netherlands, said that an analysis of the PASSION trial found that TA in combination with stent implantation did not increase the risk of adverse cardiac events over a two-year period.

There also was no increase in stent thrombosis, a rare condition that occurs when a blood clot forms on the surface of a stent, Dr. Vink said.

During the study investigators analyzed data from the PASSION trial, which involved 619 patients who suffered acute ST-segment elevation myocardial infarction (STEMI), a type of heart attack that involves complete blockage of a coronary artery. Patients were randomly assigned to receive either a drug-eluting or bare metal stent to restore blood flow. TA also was performed in half the patients.

Patients took between 100 and 500 milligram doses of aspirin and 300 milligrams of anticoagulant clopidogrel (Plavix) upon arriving at the hospital. They also took 80 to 100 milligrams of aspirin and 75 milligrams of clopidogrel daily for at least six months following the procedure.

Abciximab (ReoPro) was administered to patients as needed to prevent cardiovascular complications. Two years of follow up were completed for 598 patients.

Investigators found that there was no significant difference in outcome in patients that received TA versus those that received conventional treatment.

Cumulatively they found that 13 percent of TA patients had a recurrent heart attack, needed revascularization to clear an artery that had become clogged again or died of a cardiac-related cause as compared to 14 percent in the traditional group. About 8 percent from each group required revascularization, and patients from each group suffered similar numbers of adverse cardiac events.

The study was published in Catheterization and Cardiovascular Interventions, a journal of the Society for Cardiovascular Angiography and Interventions.

Reviewed by: 
Review Date: 
May 1, 2012
Last Updated:
May 5, 2012