Comparison of Angio Comparison of Angio JET JET Rheolytic Thrombectomy Rheolytic Thrombectomy Before Direct Infarct Artery Before Direct Infarct Artery STENT STENT ing with Direct Stenting ing with Direct Stenting Alone in Patients with Acute Alone in Patients with Acute Myocardial Infarction: Myocardial Infarction: the the JETSTENT trial JETSTENT trial David Antoniucci on behalf of the JETSTENT Investigators
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Comparison of AngioJET Rheolytic Thrombectomy Before Direct Infarct Artery STENTing with Direct Stenting Alone in Patients with Acute Myocardial Infarction:
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Comparison of AngioComparison of AngioJETJET Rheolytic Rheolytic ThrombectomyThrombectomy
Before Direct Infarct Artery Before Direct Infarct Artery STENTSTENTing with Direct Stenting Alone ing with Direct Stenting Alone
in Patients with Acute Myocardial in Patients with Acute Myocardial Infarction: Infarction:
the the JETSTENT trialJETSTENT trial
David Antoniucci on behalf of the JETSTENT Investigators
Co-Principal Investigators
• David Antoniucci, MD; Florence
• Antonio Colombo, MD; Milan
Clinical Event Adjudication Committee
• Issam Moussa, M.D., Weill Cornell Medical Center, NYC
• Gian Battista Danzi, M.D., Ospedale Maggiore , University of Milan, Milan
•Carlo Di Mario, M.D., PhD, Royal Brompton Hospital, London
Data Management and Monitoring• Director: Maria Cristina Jori, M.D. Mediolanum Cardio Research, Milan
ECG Core Laboratory• Serenella Castelvecchio, M.D. Mediolanum Cardio Research, Milan
Angiographic Core Laboratory• Maria Antonietta Bonardi, M.D. Mediolanum Cardio Research, Milan
Nuclear Scan Core Laboratory• Prof. Roberto Sciagrà, University of Florence, Florence
Steering Committe D Antoniucci, A Colombo, F-J
Neumann, A Rodriguez, A Stabile, J Gustafson
Sponsor: Medrad Interventional/Possis
After angiography and IRA wiring: thrombus grade 3 to 5
Pts with STEMI admitted within 12 hours from symptom onset
Lysis Stroke < 30 days Surgery < 6 weeks Pre-stented IRA
Rheolytic Thrombectomy +DSDirect Stenting (DS)
Study Design
Randomization 1:1 N = 500
Technique for AngioJet Use and DS
• Single pass anterograde technique
(activate AngioJet proximal to thrombus)
• Angiographic check after first AngioJet pass.
• Temporary pacemaker strongly discouraged.
• Balloon pre-dilation strongly discouraged.
• DS had to be attempted in all cases in
both arms.
• Routine Abciximab in both arms.
JETSTENT TRIAL Primary surrogate end points:
• Early ST-segment resolution (≥ 50% ST segment elevation reduction at 30 minutes)