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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EAspiration thrombectomy does not improve the extent of microvascular obstruction compared with standard percutaneous coronary intervention in patients with non-ST-elevation myocardial infarction (NSTEMI). This article presents data from the Thrombus Aspiration in Thrombus containing culprit lesions in Non-ST-Elevation Myocardial Infarction study [TATORT-NSTEMI; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01612312\u0026amp;atom=%2Fspmdc%2F13%2F19%2F24.2.atom\u0022\u003ENCT01612312\u003C\/a\u003E]. The trial protocol has been described in detail by de Waha and colleagues [\u003Cem\u003ETrials\u003C\/em\u003E 2013].\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EThrombotic Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology \u0026amp; Cardiovascular Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EThrombotic Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EAspiration thrombectomy does not improve the extent of microvascular obstruction compared with standard percutaneous coronary intervention (PCI) in patients with non-ST-elevation myocardial infarction (NSTEMI). Holger Thiele, MD, University of Leipzig, Leipzig, Germany, presented data from the Thrombus Aspiration in Thrombus containing culprit lesions in Non-ST-Elevation Myocardial Infarction study [TATORT-NSTEMI; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01612312\u0026amp;atom=%2Fspmdc%2F13%2F19%2F24.2.atom\u0022\u003ENCT01612312\u003C\/a\u003E]. The trial protocol has been described in detail by de Waha and colleagues [\u003Cem\u003ETrials\u003C\/em\u003E 2013].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EAlthough the European Society of Cardiology and the American College of Cardiology\/American Heart Association guidelines suggest that thrombectomy may be indicated in patients with NSTEMI, [Steg G et al. \u003Cem\u003EEur Heart J\u003C\/em\u003E 2012; O\u0027Gara PT et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2013] there is currently little data to support its use. The hypothesis of the TATORT-NSTEMI trial is that thrombectomy in patients that have experienced NSTEMI will improve myocardial perfusion and thrombus burden [de Waha S et al. \u003Cem\u003ETrials\u003C\/em\u003E 2013].\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn the prospective, randomized, controlled, multicenter, open-label TATORT-NSTEMI trial, 440 NSTEMI patients were randomized in 1:1 fashion to PCI or PCI with adjunctive thrombectomy [de Waha S et al. \u003Cem\u003ETrials\u003C\/em\u003E 2013]. To be eligible for the trial, patients had to have an NSTEMI with \u0026gt;20 minutes of ischemic symptoms that occurred within 72 hours prior to randomization, and identifiable culprit lesions with relevant thrombus (TIMI thrombus Grade 2 to 5). Exclusion criteria included cardiogenic shock, STEMI, unsuitable coronary morphology for thrombectomy, need for coronary artery bypass grafting (CABG), life expectancy \u0026lt;6 months, contraindication to heparin, acetylsalicylic acid, or thienopyridine.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe primary endpoint of the TATORT-NSTEMI trial was microvascular obstruction from Days 1 through 4 as measured by cardiac magnetic resonance imaging [de Waha S et al. \u003Cem\u003ETrials\u003C\/em\u003E 2013]. The secondary endpoints included infarct size, myocardial salvage, the composite of mortality, reinfarction, target vessel revascularization (TVR), and congestive heart failure at 6 months, TIMI-flow post PCI, myocardial blush grade post PCI, and enzymatic infarct size as measured by Troponin T at 24 and 48 hours.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe median age of the participants was 69 years and 68 years in the thrombectomy and standard PCI arms, respectively. Prior MI occurred in 7% and 12% of the patients in the thrombectomy and PCI arms, respectively, and the rates of prior PCI (13%) and CABG (3% vs 5%) were similar among the arms. Most patients had a TIMI thrombus grade of 3 to 5, and the median GRACE score was 145 in the thrombectomy arm and 137 in the PCI arm.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EResults of the TATORT-NSTEMI trial demonstrated no significant difference in microvascular obstruction between the thrombectomy and standard PCI arms (p=0.74). In addition, there was no significant difference in the extent of the microvascular obstruction between the treatment arms (p=0.17). Furthermore, there was no significant difference in any of the secondary endpoints, including clinical outcome at 6 months.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EProf. Thiele stated that the data from the TATORT-NSTEMI trial indicate that aspiration thrombectomy did not decrease the extent of microvascular obstruction as measured by cardiac MRI when compared with standard PCI.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/19\/24.2\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022The editors would like to thank the many members of the Transcatheter Cardiovascular Therapeutics presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-2052696695\u0022 data-figure-caption=\u0022The editors would like to thank the many members of the Transcatheter Cardiovascular Therapeutics presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure1\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/19\/24.2\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/19\/24.2\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure1\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/19\/24.2\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/13788\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\n            \u003Cp id=\u0022p-9\u0022 class=\u0022first-child\u0022\u003EThe editors would like to thank the many members of the Transcatheter Cardiovascular Therapeutics presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2013 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/13\/19\/24.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nznkj1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nznkj1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}