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. 2025 Mar;21(4):237-243.
doi: 10.1080/14796678.2025.2472581. Epub 2025 Mar 4.

Assessing angiographic results of saline autotransfusion and thrombus aspiration in STEMI patients

Rekha V  1 , Sudhakar Rao  2 , Krishnananda Nayak  1 , Manjoosha M  1 , Jyothi Samanth  1 , Padmakumar R  3
Affiliations

Assessing angiographic results of saline autotransfusion and thrombus aspiration in STEMI patients

Rekha V et al. Future Cardiol. 2025 Mar.

Abstract

Background: Effective myocardial reperfusion in ST-Elevation Myocardial Infarction (STEMI) remains challenging despite advancements in primary percutaneous coronary intervention (PCI). This study evaluates the impact of thrombus aspiration (TA) and saline autotransfusion (SAT) compared to standard PCI (NOTA) on coronary flow dynamics and myocardial perfusion.

Research design and method: This prospective cohort study enrolled 157 STEMI patients who underwent primary PCI. Participants were divided into two groups: TA+SAT (n = 80) and NOTA (n = 77). Clinical parameters such as blood pressure, ejection fraction, ST-segment resolution, thrombolysis in myocardial infarction (TIMI) flow grades, corrected TIMI frame count (CTFC), and myocardial infarction (MI) location were assessed.

Results: Patients in the TA+SAT group exhibited significantly better short-term myocardial reperfusion, as indicated by superior ST-segment resolution (p = 0.010) and lower CTFC values (p < 0.001). Blood pressure was significantly lower in the TA+SAT group (p = 0.042). However, ejection fraction improvement at one month was not statistically significant. TIMI and TMPG flow grades were comparable between groups.

Conclusion: The TA+SAT approach demonstrated improved coronary flow dynamics and better short-term myocardial reperfusion in STEMI patients without additional pharmacological interventions. These findings suggest that TA+SAT may serve as a valuable adjunct to PCI, warranting further investigation into its long-term clinical benefits.

Keywords: ST-elevation myocardial infarction; ST-segment resolution; STEMI; primary percutaneous coronary intervention; saline autotransfusion; thrombus aspiration.

Plain language summary

ST-segment elevation myocardial infarction (STEMI) is a type of heart attack caused by a blocked artery that stops blood from reaching the heart. Immediate treatment is crucial to restore blood flow and prevent heart damage. The most common treatment is primary percutaneous coronary intervention (PPCI), a procedure that uses a thin tube (catheter) to open the blocked artery and insert a stent to keep it open. However, blood clots and debris from the blockage can sometimes reduce the effectiveness of this treatment.In this study, we compared two treatment approaches in 157 patients with STEMI to see if adding two extra steps – thrombus aspiration (TA) and saline autotransfusion (SAT) – could improve heart recovery. Thrombus aspiration is a technique where a special suction tool removes the clot before placing the stent. Saline autotransfusion is a method where a saltwater solution is injected into the artery to wash away small debris and improve blood flow.We divided the patients into two groups:Group1 (TA+SAT): Patients received both thrombus aspiration and saline autotransfusion.Group2 (NOTA): Patients received the standard treatment without these additional steps.Key Findings: Patients in the TA+SAT group had better short-term blood flow improvement in their heart arteries compared to the NOTA group.Their ST-segment resolution (a sign of improved heart recovery) was significantly better.Their blood pressure was lower, which may indicate better heart function after treatment.Their ejection fraction (heart pumping ability) improved slightly after one month, but the difference between groups was small.These findings suggest that thrombus aspiration and saline autotransfusion may help improve short-term blood flow and heart recovery after a heart attack. However, more research is needed to confirm whether these benefits translate to better long-term outcomes.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

References

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    2. • This study protocol investigates the effectiveness of aggressive hydration in preventing contrast-induced nephropathy in STEMI patients undergoing primary PCI.

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