Reduction of atherothrombotic burden before stent deployment in non-ST elevation @entity1187 : Reduction of myocardial necrosis achieved with nose-dive manual XXXX aspiration (REMNANT) trial. A volumetric @entity5642 study.

@entity1 @entity715 @entity5642 @entity1187
OBJECTIVES: To test whether @entity715 aspiration (TA) reduces the atherosclerotic burden in culprit lesions and "facilitate" percutaneous coronary intervention with stent (S-PCI) among @entity1 with non-ST elevation @entity1187 (NSTE-ACS). BACKGROUND: Evidence on the effects of TA adjunctive to S-PCI in NSTE-ACS is limited and controversial. METHODS: TA was defined "aggressive" when using 7F devices or a catheter/artery ratio >0.6, "conservative" with 6F, and a catheter/artery ratio  <=0.6. Angiography and @entity5642 ( @entity5642 ) were performed at baseline, after TA and after stent deployment. RESULTS: TA was accomplished in 61/76 @entity1 (80%) with NSTE-ACS. The aspirated material was red @entity715 in 23% and plaque fragments in 49% of cases. Compared with baseline, TA was associated with an 82% increase in minimal lumen diameter and a 15% reduction in diameter stenosis (P   <   0.001 for both). After TA, @entity5642 documented a 24 and 16% increase in minimal lumen area and lumen volume, respectively (P   <   0.001 for both), a 7% decrease in area stenosis through an 11% reduction of plaque   +   media volume (P   <   0.001). When compared with "conservative", an "aggressive" TA was associated with a more pronounced reduction in percent area stenosis (P   <   0.05) and an increase in percent stent expansion (P   <   0.001). The plaque   +   media volume reduction after TA was correlated with stent expansion (r   =   0.261, P   =   0.046). CONCLUSIONS: Manual TA reduces atherothrombotic burden in culprit lesions of NSTE-ACS @entity1 before S-PCI and, when deep plaque removal is obtained, TA optimizes subsequent stent expansion.    2015 Wiley Periodicals, Inc.
