Stent-Retriever Thrombectomy in STEMI With Large Thrombus Burden: The RETRIEVE AMI Randomized Trial
Authors' conclusion
RETRIEVE AMI demonstrates the feasibility of Solitaire X SRT in STEMI with LTB. Prestent thrombus volume was not different between SRT, MA, or no thrombus modification, although SRT extracted larger thrombus volume than MA. Larger multicenter studies using optical coherence tomography-based criteria are needed to minimize variability and enhance comparative assessments.
Study context
- Population
- STEMI patients with large thrombus burden (LTB) (TIMI thrombus grade ≥4)STEMI patients with LTB enrolled
- Participants
- 81 patients
- Comparison
- Solitaire X SRT vs Export manual aspiration (MA) in STEMI patients with LTB
- SRTn = 26
- MAn = 27
- Primary endpoint
- Prestent thrombus volume by optical coherence tomography, SRT vs either comparator
Methodological detailssingle-center
- Single-center
Primary result
As reported in the abstract
SRT
7.7
IQR 2.3–18.6
MA
4.8
IQR 1.8–8.4
No thrombus modification
9.8
IQR 4.5–18.1
SRT vs MA: P = 0.17 · SRT vs no thrombus modification: P = 1.00
Further findings
Baseline thrombus volume
| Outcome | SRT | MA | No thrombus modification | P value |
|---|---|---|---|---|
| Prestent thrombus burdenSRT vs no thrombus modification · significantly reduced with SRT | 12.8% (IQR 4.4%–21.5%) | 13.0% (IQR 3.8%–19.4%) | 22.8% (IQR 10.4%–27.7%) | P = 0.016 |
| Prestent thrombus burdenMA vs no thrombus modification · significantly reduced with MA | P = 0.003 |
- Baseline thrombus volume: P = 0.04
Crossover
- SRT was performed in 26 cases (one crossover)
Safety
Device-related arterial complications, clinically relevant arterial injury, MACCE · in-hospital and 6-month
- No device-related arterial complications or cerebrovascular events occurred in the SRT arm
- No device-related clinically relevant arterial injury; MACCE did not differ between arms
Original publication
Summarised from the published abstract; every number is checked against it