Carga trombótica intracoronaria y uso de tromboaspiración en pacientes con síndrome coronario agudo con elevación del ST, Fundación Cardio Infantil 2016
Thesis
Background: Although it is clear that the routine use of thrombus aspiration (TA) in patients with acute coronary syndrome with ST elevation does not bring a benefit compared to conventional primary percutaneous coronary intervention, there are still gaps in the role of TA in the setting of higher thrombus burden (TIMI thrombus grade). This intracoronary thrombotic grade can be reclassified after passing a guidewire or pre dilatation with a small balloon; however, this reclassification has not been described in clinical studies. The purpose of this study is to determine if the classification and/or reclassification of the thrombotic grade is associated with the selective use of TA in patients diagnosed with acute coronary syndrome with ST elevation. Methodology: Retrospective descriptive study of patients diagnosed with acute coronary syndrome with ST elevation in 2016, in which the use of manual TA was evaluated according to the intracoronary thrombus grade. Results: A total of 173 patients were included, with a mean age of 62 years, 78% were men. In 30% of these patients TA was performed, while in the remaining 70% conventional coronary interventions were performed. From the 52 patients who underwent TA, 98% (51/52) had a higher thrombus burden (thrombus grade TIMI> / = 4); compared to 39,6% (48/121) of the group in which TA was not used, higher thrombus burden that was associated with the use of TA (p <0.0001). No significant difference was found in the final TIMI flow between the two groups. There were no cerebrovascular events during the hospital stay in the TA group. Conclusion: High thrombotic burden classified by the scale TIMI significantly associated with the use of manual trombaspiración in our hospital, the use of this technique is not related with the increase of major cardiovascular events.
