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. 2022 Mar:36:83-88.
doi: 10.1016/j.carrev.2021.05.021. Epub 2021 May 27.

Trends and Outcomes of Uilization of Thrombectomy During Primary Percutaneous Coronary Intervention

Michael Megaly  1 , Ramy Sedhom  2 , Ayman Elbadawi  3 , Marwan Saad  4 , Mohamed Omer  5 , Emmanouil S Brilakis  6 , Mir B Basir  7 , Farouc A Jaffer  8 , Mohammad Zaidan  7 , Mohammad Alqarqaz  7 , Khaldoon Alaswad  9
Affiliations

Trends and Outcomes of Uilization of Thrombectomy During Primary Percutaneous Coronary Intervention

Michael Megaly et al. Cardiovasc Revasc Med. 2022 Mar.

Abstract

Background: To describe the national trends and outcomes of contemporary thrombectomy use for primary percutaneous coronary intervention (PCI) from 2016 to 2018.

Methods: We queried the Nationwide Readmission Database (NRD) from January 2016 to December 2018 to identify patients who underwent primary PCI and thrombectomy. We conducted a multivariate regression analysis to identify variables associated with in-hospital mortality and stroke in patients undergoing primary PCI and those who underwent thrombectomy.

Results: We identified 409,910 total hospitalizations who underwent primary PCI. Thrombectomy was used in 62,446 records (15.2%) with no change in the trend over the study period (p trend = 0.52). Thrombectomy was more utilized in patients who had more cardiogenic shock and use of mechanical circulatory devices. The overall incidence of in-hospital mortality and stroke were 5.6% and 1.1%, respectively. The incidence of in-hospital mortality (6.7% vs. 5.4%, p < 0.001) and strokes (1.3% vs. 1.0%, p < 0.001) were higher in the thrombectomy group. On multivariable regression analysis adjusting for high-risk features, thrombectomy was not independently associated with in-hospital mortality [1.036, 95% CI (0.993-1.080), p = 0.100], but was associated with a higher risk of stroke [OR 1.186, 95% CI (1.097-1.283), p < 0.001].

Conclusion: During primary PCI, thrombectomy was used in 1 of 6 cases, and its use has been stable over 2016-2018. The use of thrombectomy was associated with a higher risk of stroke, but not in-hospital death.

Keywords: Primary PCI; STEMI; Stroke; Thrombectomy.

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Conflict of interest statement

Declaration of competing interest Khaldoon Alaswad: consulting/speaker honoraria from Boston Scientific, Cardiovascular Systems Inc., Abbott Vascular, Teleflex. Mir Basir: Consulting/Speaker Abbott Vascular, Abiomed, Cardiovascular Systems, Chiesi, Zoll. Emmanouil Brilakis: consulting/speaker honoraria from Abbott Vascular, American Heart Association (associate editor Circulation), Amgen, Biotronik, Boston Scientific, Cardiovascular Innovations Foundation (Board of Directors), ControlRad, CSI, Ebix, Elsevier, GE Healthcare, InfraRedx, Medtronic, Siemens, and Teleflex; research support from Regeneron and Siemens. Shareholder: MHI Ventures. Farouc Jaffer: sponsored research grants from Siemens, Canon, Shockwave, and Teleflex; consulting agreements with Boston Scientific, Siemens, Biotronik, and Magenta Medical; equity interest, Intravascular Imaging. Massachusetts General Hospital has patent licensing arrangements with Canon, Terumo, and Spectrawave; Dr. Jaffer has a right to receive licensing royalties. All other authors have nothing to disclose.

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