Studies have not demonstrated consistent outcomes following thrombus aspiration in Primary Percutaneous Coronary Intervention (PPCI). We investigated the relationship between thrombus aspiration and microvascular obstruction as measured using Index of Microcirculatory Resistance (IMR) immediately following PPCI and Left Ventricle Function Improvement measured using Global Longitudinal Strain (GLS) six months following PPCI. Our aim is to determine microvascular obstruction and left ventricle function improvement six months following thrombus aspiration during PPCI. This was a single-center, observational, prospective non-randomized study involving 45 patients with thrombus score 4–5 (defined as high thrombus burden) and Thrombolysis in Myocardial Infarction (TIMI) flow of 0–2 who subsequently underwent PPCI. Thrombus aspiration was conducted based on physician discretion. The IMR was measured immediately following the procedure. All patients underwent echocardiography to measure GLS at 24 h, 3 months and 6 months following PPCI. Thirty-three (73%) patients underwent thrombus aspiration during PPCI and twelve (27%) patients underwent the conventional PPCI. No significant difference in IMR was found between the group that underwent thrombus aspiration and the group that underwent conventional PCI (51.9 ± 41.5 vs 47.1 ± 35.6 p = 0.723). TIMI flow after PPCI was worse in thrombus aspiration group (OR 5.2 [1.2–23.2], p = 0.041). There was no difference in GLS between two groups at 6-month follow-up (− 13.0 ± 3.4 vs − 12.8 ± 4.6, p = 0.912). This study indicates no benefit of thrombus aspiration during PPCI in reducing either microvascular obstruction or left ventricular function at 6-month follow-up for patients with high thrombus burden. Nevertheless, further studies are required before definite conclusions can be made.

中文翻译：

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血栓抽吸对高血栓负担患者微循环阻力和心室功能的影响

尚无研究表明原发性经皮冠状动脉介入治疗（PPCI）中血栓抽吸后的结果一致。我们调查了血栓抽吸与微血管阻塞之间的关系，如在PPCI之后立即使用微循环阻力指数（IMR）进行测量，以及在PPCI六个月后使用全球纵向应变（GLS）进行测量的左室功能改善。我们的目标是确定PPCI术后血栓抽吸六个月后微血管阻塞和左心室功能改善。这是一项单中心，观察性，前瞻性，非随机性研究，涉及45例血栓评分为4-5（定义为高血栓负担）且血栓溶解度为0-2的心肌梗死（TIMI）血流患者，随后接受了PPCI。根据医师的判断进行血栓抽吸。手术后立即测量IMR。所有患者均在PPCI后24小时，3个月和6个月接受超声心动图测量。33例（73％）患者在PPCI期间接受了血栓抽吸术，而12例（27％）进行了常规PPCI。接受血栓抽吸的组与接受常规PCI的组之间的IMR差异无统计学意义（51.9±41.5 vs 47.1±35.6 p = 0.723）。在血栓抽吸组中，PPCI后TIMI血流较差（OR 5.2 [1.2–23.2]，p = 0.041）。两组在6个月的随访中，GLS没有差异（− 13.0±3.4与− 12.8±4.6，p = 0.912）。这项研究表明，对于有高血栓负担的患者，在6个月的随访中，PPCI期间进行血栓抽吸对减少微血管阻塞或左心室功能无益处。尽管如此，在得出明确结论之前还需要进一步研究。