Rheolytic Thrombectomy

Rheolytic thrombectomy is the procedure in which a jet of saline is directed at the thrombus in the coronary artery from the tip of a catheter using an AngioJet system. The slurry is sucked through another channel of the catheter. A recent study presented at the American College of Cardiology 2010 meeting found that the risk of major adverse coronary events (MACE) was halved by using rheolytic thrombectomy prior to direct stenting in ST elevation myocardial infarction (STEMI). This was also linked to a lower death rate at one month and six months. There were 256 patients in the thrombectomy plus stenting group and 245 patients in the direct stenting group. Abciximab was used in both groups. The mean procedure time was increased in the thrombectomy group (60 minutes vs 46 minutes; p < 0.001). In spite of this 50% ST resolution at 30 minutes, the primary outcome was 86% with rheolytic thrombectomy while it was 79% with direct stenting alone (p = 0.043). The trial summary is available at: http://www.cardiosource.com/clinicaltrials/trial.asp?trialID=1915