Connelly, Kim A

Dick, Alexander J

Ghugre, Nilesh R

Wright, Graham A

Zia, Mohammad I

English

PubMed

Dick Alexander J

Wright Graham A

Connelly Kim A

Ghugre Nilesh R

Zia Mohammad I

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Journal of Cardiovascular Magnetic Resonance

Thrombus aspiration during primary percutaneous coronary intervention leads to reduced myocardial edema and microvascular obstruction in infarct segment post acute myocardial infarction

Mohammad I Zia

Nilesh R Ghugre

Kim A Connelly

Graham A Wright

Alexander J Dick

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POSTER PRESENTATION Open Access
Thrombus aspiration during primary
percutaneous coronary intervention leads to
reduced myocardial edema and microvascular
obstruction in infarct segment post acute
myocardial infarction
Mohammad I Zia*, Nilesh R Ghugre, Kim A Connelly, Graham A Wright, Alexander J Dick
From 2011 SCMR/Euro CMR Joint Scientific Sessions
Nice, France. 3-6 February 2011
Introduction
Thrombus aspiration has been previously shown to
improve myocardial blush grade during primary percu-
taneous coronary intervention (PCI) for acute myocar-
dial infarction (AMI), with no impact on mortality or
reinfarction. The impact of thrombus aspiration on
myocardial edema and hemorrhage is unknown.
Purpose
Our goal was to determine the impact of thrombus
aspiration during primary PCI on myocardial edema and
hemorrhage post AMI.
Methods
Thirty-seven patients were enrolled post AMI and
underwent CMR on a GE Signa Excite, 1.5T scanner
with a 8-channel receive coil at 48 hours post MI. T2
maps were computed from a previously validated car-
diac-gated spiral imaging sequence with T2 preparations
yielding TEs=2.9,24.3,88.2,184.2 ms to assess myocardial
edema. The T2* sequence was a multiecho acquisition
with 8 echoes (between 1.4 and 12.7ms) acquired at
TR=14.6ms. T2-weighted imaging using a breath-hold
triple IR fast spin echo sequence and delayed hyperen-
hancement (DHE) were also performed. We retrospec-
tively stratified patients into those that had received
thrombus aspiration versus not, based on the operator’s
discretion.
Results
We compared 26 patients (mean age:59.4 years; 5 ante-
rior infarcts; mean CK:2022 IU/L) that did receive
thrombus aspiration versus eleven patients (mean
age:58.5 years; 4 anterior infarcts; mean CK:2070 IU/L)
that did not during primary PCI. The mean T2 was
higher in the infarct segment (IS) compared to remote
segment (RS) in both groups of patients, i.e. those that
did receive thrombus aspiration (51.5 ms vs 40.9 ms;
p<0.0001) versus those that did not (63.6 ms vs 41.2 ms;
p<0.0001). The mean T2* was significantly lower in the
IS compared to RS in both patients that did receive
thrombus aspiration (25.6 ms vs 36.5 ms; p<0.0001) ver-
sus those that did not (26.3 ms vs 39.2 ms; p<0.004).
The mean T2 was significantly lower in the IS of
patients that did receive thrombus aspiration versus
those that did not (51.5 ms vs 63.6 ms; p<0.0001). The
mean T2* was equivalent in the IS of both patient
groups (25.6 ms vs 26.3 ms; p=0.77). There was a lower
incidence of microvascular obstruction (MVO) in the
thrombus aspiration group (58% vs 91%; p=0.046).
Conclusions
Our retrospective study demonstrates that thrombus
aspiration does lead to reduced myocardial edema and
MVO in the IS, compared to patients that did not
receive this therapy during AMI. Thrombus aspiration
seems to reduce the area at risk during myocardial
infarction which may prevent deleterious left ventricular
remodeling.
Sunnybrook Health Sciences Centre, Toronto, ON, Canada
Zia et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):P133
http://jcmr-online.com/content/13/S1/P133
© 2011 Zia et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
Published: 2 February 2011
doi:10.1186/1532-429X-13-S1-P133
Cite this article as: Zia et al.: Thrombus aspiration during primary
percutaneous coronary intervention leads to reduced myocardial
edema and microvascular obstruction in infarct segment post acute
myocardial infarction. Journal of Cardiovascular Magnetic Resonance 2011
13(Suppl 1):P133.
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Zia et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):P133
http://jcmr-online.com/content/13/S1/P133
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Thrombus aspiration during primary percutaneous coronary intervention leads to reduced myocardial edema and microvascular obstruction in infarct segment post acute myocardial infarction

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