Primary percutaneous coronary intervention and the role of thrombus aspiration

PhD ceremony: Ms. T. Svilaas, 14.45 uur, Academiegebouw, Broerstraat 5, Groningen

Title: Primary percutaneous coronary intervention and the role of thrombus aspiration

Promotor(s): prof. F. Zijlstra

Faculty: Medical Sciences

Removing a clot is better than angioplasty

After an acute hart attack, removing any clots (thrombus aspiration) is a better method than angioplasty. It reduces chances of patients dying within a year by nearly half, according to the research by Tone Svilaas.

Svilaas studied the effects of thrombus aspiration on 1071 patients who had suffered acute myocardial infarction. Half of the patients received standard angioplasty treatment while the other half were treated with thrombus aspiration. Svilaas concluded that thrombus aspiration led to good perfusion of the heart more often than angioplasty.

Of the patients treated with thrombus aspiration, 3.6 percent had died one year after treatment. The mortality rate in the control group was 6.7 percent. Those who underwent thrombus aspiration also had a much slighter chance of having a second heart attack.

Svilaas conducted her research together with colleagues from the departments of Cardiology and Pathology of the University Medical Center Groningen. She already published articles about the research in the renowned medical journals, The New England Journal of Medicine and The Lancet.

Acute myocardial infarction is the result of an atherosclerotic plaque (the result of ‘hardening’ of the arteries) tearing in a coronary artery. A clot (thrombus) is immediately formed where the plaque tears and this completely blocks the coronary artery. The part of the heart muscle that the artery provided with blood then dies due to lack of oxygen.

Angioplasty is the common treatment after a heart attack: a small balloon is used to widen the coronary artery and then a tube or stent is inserted. The thrombus itself is not removed. This does happen in thrombus aspiration, where the thrombus is sucked away through a thin tube. Completely removing the clot not only improves blood supply to the heart muscle but also prevents it from later coming loose and causing further damage to the artery further on.

Tone Svilaas (Norway, 1973) is training as a cardiologist at the Department of Cardiology of the UMCG Thorax Centre, which is also where conducted her PhD research.