JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
Add like
Add dislike
Add to saved papers

The impact of initial and residual thrombus burden on the no-reflow phenomenon in patients with ST-segment elevation myocardial infarction.

BACKGROUND: Limited data are available on the clinical significance of residual thrombi after thrombectomy and prestenting reduced epicardial coronary flow in ST-segment elevation myocardial infarct (STEMI) patients.

MATERIALS AND METHODS: The incidence of the no-reflow phenomenon, defined as a final thrombolysis in myocardial infarction (TIMI) flow grade of up to 2 or a myocardial blush grade of up to 1, was compared in 260 STEMI patients undergoing primary percutaneous coronary intervention according to thrombotic burden. Large thrombotic burden (LTB), defined as a thrombus score of at least 3, was observed in 134 patients, among whom 66 (49.3%) underwent aspiration thrombectomy. No-reflow incidence was compared on the basis of thrombectomy treatment, thrombus residue after thrombectomy, and prestenting TIMI flow grade.

RESULTS: The no-reflow phenomenon occurred most frequently in LTB patients without thrombectomy, followed by those who underwent thrombectomy and the small thrombus burden group (33.8 vs. 21.2 vs. 10.3%, respectively, P<0.001). Patients with a prestenting residual thrombus or a TIMI flow grade of up to 2 had higher no-reflow incidence than those with no visible prestenting thrombus and a TIMI flow grade of 3 (74 vs. 6.2%, P<0.001). Multiple logistic regression analysis identified a prestenting TIMI flow grade of up to 2 (odds ratio 36.422, 95% confidence interval 13.952-95.079) as an independent predictor of the no-reflow phenomenon.

CONCLUSION: Manual thrombus aspiration reduced no-reflow incidence in STEMI patients with LTB. However, even after thrombectomy, prestenting residual thrombi and decreased coronary flow were related to a higher occurrence of the no-reflow phenomenon.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app