Usefulness of Local Delivery of Thrombolytics Before Thrombectomy in Patients with ST-elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Proponente Carlo Gaudio - Professore Ordinario
Sottosettore ERC del proponente del progetto
Componenti gruppo di ricerca
Componente Categoria
Stefano Strano Componenti il gruppo di ricerca
Maria Cristina Acconcia Componenti il gruppo di ricerca
Componente Qualifica Struttura Categoria
Pelliccia Francesco Ricercatore Scienze Cardiovascolari Altro personale Sapienza o esterni
Viceconte Nicola Ricercatore Scienze Cardiovascolari Altro personale Sapienza o esterni

Thrombus aspiration during percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is said to reduce PCI-induced distal occlusion.1-3 In an attempt to enhance its effectiveness, thrombus aspiration is often coupled with glycoprotein IIb/IIIa (GpIIb/IIIa) inhibitors, though conflicting results on this strategy have been reported so far.4-5 Indeed, GP IIb/IIIa antagonists inhibits the final common pathway that leads to platelet aggregation and leucocyte plugging which are the main components of fresh thrombi,6 but are unable to modify the morphologic characteristics of older thrombi (i.e., lytic changes and organization), which are found in nearly ¿50% of STEMI patients.7,8 Fibrinolytic agents, conversely, can weaken the structure of older thrombi and therefore have the potential to facilitate manual aspiration.9 Accordingly, we designed the DISSOLUTION (Delivery of thrombolytIcs before thrombectomy in patientS with ST-elevatiOn myocardiaL infarction Undergoing primary percuTaneous coronary interventION) trial, a prospective, randomized, single-blind trial in order to evaluate the hypothesis that intrathrombus delivery of thrombolysis prior to manual thrombectomy can enhance the efficacy of thrombus aspiration in primary PCI.


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