Am J Cardiovasc Dis 2013;3(2):71-78
Original Article
“Lone aspiration thrombectomy” without stenting in young patients with ST
elevation myocardial infarction
Gohar Jamil, Mujgan Jamil, Ahmed Abbas, Swapna Sainudheen, Sadek Mokahal, Anwer Qureshi
Division of Cardiology, Tawam Hospital, PO Box 15258, Al Ain, United Arab Emirates; Department of Internal Medicine,
Tawam Hospital, PO Box 15258, Al Ain, United Arab Emirates
Received February 6, 2013; Accepted April 3, 2013; Epub June 10, 2013; Published June 15, 2013
Abstract: Plaque rupture with thrombotic occlusion without severe underlying coronary atherosclerosis is frequently
observed during primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction
(STEMI). These lesions are stented even if post thrombectomy mild underlying coronary artery disease (CAD) is noted. The
value of mechanical thrombus aspiration alone “lone aspiration thrombectomy” (LAT) without stenting is not well studied.
We present a retrospective analysis of patients receiving LAT as the only pPCI therapy for STEMI. Between January 2008
and March 2012, 202 young patients underwent pPCI for acute STEMI at our institution. From this group 10 patients had
LAT as definitive therapy. LAT was favored if post thrombectomy minimal underlying CAD was noted, and concerns
regarding long term treatment cost and compliance with dual antiplatelet therapy (DAPT) was an issue. All patients
received ASA, clopidogrel, heparin and eptifibatide. DAPT was maintained for at least 1 month. One patient was lost to
follow-up. At one month, all remaining 9 patients were free of MACE. At six weeks one patient had recurrent STEMI after
abruptly discontinuing all his medications. Re-occlusion at the site of prior plaque rupture was stented, and treatment
compliance was urged. Short term follow up at 2 months available for 5 patients and 2 years for 3 patients revealed no
adverse consequences, the remaining patients had returned to their home countries. Conclusion: In selected young
patients presenting with acute STEMI, LAT without balloon angioplasty or stenting is feasible and is associated with
favorable short and long-term outcome. (AJCD1302001).
Keywords: Aspiration thrombectomy, percutaneous coronary intervention, angioplasty, ST-segment elevation myocardial
infarction, young patients, coronary artery disease
Address correspondence to: Dr. Gohar Jamil, Tawam Hospital, PO Box 15258, Al Ain, UAE. Phone: 00971501398358;
Fax: 0097137672560; E-mail goharjamil@gmail.com
Original Article
“Lone aspiration thrombectomy” without stenting in young patients with ST
elevation myocardial infarction
Gohar Jamil, Mujgan Jamil, Ahmed Abbas, Swapna Sainudheen, Sadek Mokahal, Anwer Qureshi
Division of Cardiology, Tawam Hospital, PO Box 15258, Al Ain, United Arab Emirates; Department of Internal Medicine,
Tawam Hospital, PO Box 15258, Al Ain, United Arab Emirates
Received February 6, 2013; Accepted April 3, 2013; Epub June 10, 2013; Published June 15, 2013
Abstract: Plaque rupture with thrombotic occlusion without severe underlying coronary atherosclerosis is frequently
observed during primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction
(STEMI). These lesions are stented even if post thrombectomy mild underlying coronary artery disease (CAD) is noted. The
value of mechanical thrombus aspiration alone “lone aspiration thrombectomy” (LAT) without stenting is not well studied.
We present a retrospective analysis of patients receiving LAT as the only pPCI therapy for STEMI. Between January 2008
and March 2012, 202 young patients underwent pPCI for acute STEMI at our institution. From this group 10 patients had
LAT as definitive therapy. LAT was favored if post thrombectomy minimal underlying CAD was noted, and concerns
regarding long term treatment cost and compliance with dual antiplatelet therapy (DAPT) was an issue. All patients
received ASA, clopidogrel, heparin and eptifibatide. DAPT was maintained for at least 1 month. One patient was lost to
follow-up. At one month, all remaining 9 patients were free of MACE. At six weeks one patient had recurrent STEMI after
abruptly discontinuing all his medications. Re-occlusion at the site of prior plaque rupture was stented, and treatment
compliance was urged. Short term follow up at 2 months available for 5 patients and 2 years for 3 patients revealed no
adverse consequences, the remaining patients had returned to their home countries. Conclusion: In selected young
patients presenting with acute STEMI, LAT without balloon angioplasty or stenting is feasible and is associated with
favorable short and long-term outcome. (AJCD1302001).
Keywords: Aspiration thrombectomy, percutaneous coronary intervention, angioplasty, ST-segment elevation myocardial
infarction, young patients, coronary artery disease
Address correspondence to: Dr. Gohar Jamil, Tawam Hospital, PO Box 15258, Al Ain, UAE. Phone: 00971501398358;
Fax: 0097137672560; E-mail goharjamil@gmail.com
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