This article is more than 5 years old. Information may no longer be current.

JETSTENT: Thrombectomy before stenting produced benefits over direct stenting alone

Kastrati A. J Am Coll Cardiol. 2010;doi:10.1016/j.jacc.2010.07.003.

Migliorini A. J Am Coll Cardiol. 2010;doi:10.1016/j.jacc.2010.06.011.

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

Rheolytic thrombectomy plus direct stenting resulted in a decrease in major adverse coronary events vs. direct stenting alone, although the primary efficacy endpoints set by the researchers were not met, according to the results of the JETSTENT trial.

The multicenter, international, randomized, prospective study included patients (n=501) with acute MI, angiographic evidence of thrombus grade 3 to grade 5 and a reference vessel diameter ≥2.5 mm. Patients were allocated to either rheolytic thrombectomy before direct infarct artery stenting (n=256) or direct stenting alone (n=245). Co-primary endpoints were early ST-segment resolution and technetium-99m-sestamibi infarct size, and researchers considered an alpha value equal to 0.05 achieved by both co-primary surrogate endpoints or an alpha value equal to 0.025 for a single primary surrogate endpoint as evidence of statistical significance.

Study results showed that ST-segment resolution was more frequent in the thrombectomy arm (85.8%) vs. the direct stenting alone arm (78.8%, P=.043), whereas no difference between groups was revealed in the other surrogate endpoints. Researchers also found that the 6-month major adverse cardiovascular events rate was 11.2% in the thrombectomy arm and 19.4% in the direct stenting alone arm (P=.011), and the 1-year event-free survival rates were 85.2 ± 2.3% for the thrombectomy patients and 75 ± 3.1% for the direct stenting alone arm (P=.009).

“Although the primary efficacy endpoints were not met, the results of this study support the use of rheolytic thrombectomy before infarct artery stenting in patients with acute MI and evidence of coronary thrombus,” the researchers wrote in the study. “However, the routine use of rheolytic thrombectomy in acute MI should be confirmed by future larger trials.”

In an accompanying editorial, Adnan Kastrati, MD, Robert A. Byrne, MB, BCH, and Albert Schömig, MD, all from the Technische Universität in Munich, wrote that the researchers’ interpretation of the results may be spurred by their attraction to the concept of thrombectomy than by the strength of the evidence shown in the study.

“Device complexity may be a significant limitation of rheolytic thrombectomy, especially in out-of-hours and emergency situations, and what evidence is available is far from being a motivation for its adoption into routine practice,” they wrote.

Follow CardiologyToday.com on Twitter.