02/29/2008 From the New England Journal of Medicine February 2008 comes an original article by a team of researchers in the Netherlands led by Dr Svilaas. The researchers looked at the outcomes of a new type of procedure to treat heart attacks which involves aspirating(sucking) clot out of the blocked coronary artery using a catheter as soon as is practical after a Heart Attack.

1071 patients had precedures performed between January 2005 and December 2006 in the Netherlands. They were divided into 2 treatment groups, one group having thrombus(clot) aspirated prior to other procedures including balloon dilatation(angioplasty) and stent insertion. The other group did not have the clot removed, and had either a stent inserted or angioplasty.

The results showed that aspiration of clot material is possible in a large majority of patients presenting with myocardial infarction (heart attack) who show typical change seen on the heart trace(ST elevation). As compared with balloon angioplasty as an initial step after a heart attack, aspiration before inserting a stent resulted in improved return of bloodflow to the damaged area of heart muscle, shown by a clear improvement in the usual measurable signs of heart damage following a heart attack(myocardial blush grade, increased resolution of ST-segment elevation, and reduced residual ST-segment deviation) The study shows that removal of clot followed by either stenting or balloon dilatation reduces damage to the heart caused by a heart attack in this one centre, and now a larger study is needed to confirm their findings.