Thrombus Aspiration for OcLuded Coronary Artery Enhanced With Distal Injection Of Abciximab

Phase 4 Study of Primary Angioplasty Combined Distal Injection of Abciximab to Thrombus and Aspiration With Catheter

Aims: (to prove that) The distal injection of IIb IIIa platelet receptor blocker to the thrombus occlusion is better than normal injection during primary percutaneous intervention (PCI) for the treatment of acute myocardial infarction. Using this modification of injection method the investigators can achieve less microvascular damage and a reduction of the infarct size with a significant improvement of the outcome at six months.

There are some evidence about the utilization of aspiration catheter (Indication class IIb with level of evidence B in European Guidelines) and intravenous abciximab (indication Class IIa an level of evidence A in European Guidelines) in primary PTCA. Direct intracoronary injection of abciximab get smaller infarct size than intravenous injection. The hypothesis of our study are that direct distal injection of abciximab by aspiration catheter will be better than proximal intracoronary injection with reduction in infarct size and microvascular damage quantified by Magnetic resonance (MR) and 6 months mortality.

Inclusion Criteria:

• Myocardial infarction patients between 3 and 12 hours after symptoms onset

Exclusion Criteria:

• Hemodynamic instability
• TIMI flow 2 or 3
• Life expectance less than 6 months
• Contraindication to AAS, clopidogrel or abciximab
• Severe tortuosity of occluded vessel