THE LASER-AMI STUDY - Excimer Laser Versus Manual Thrombus Aspiration in Acute Myocardial Infarction (LASER-AMI)
Myocardial Infarction
About this trial
This is an interventional treatment trial for Myocardial Infarction focused on measuring Myocardial Infarction, No-reflow, Primary PCI, Coronary no-reflow phenomenon, Primary percoutaneous coronary intervention (primary PCI)
Eligibility Criteria
Inclusion Criteria:
- Onset of symptoms of MI less than 12 hours prior to enrolment;
- ST-segment elevation of at least 2 mm in two or more contiguous leads;
- Vessel and lesion amenable to both coronary laser and manual trhombus aspiration (lack of marked vessel/lesion tortuosity or calcification; reference vessel diameter >2.5 mm in diameter);
- Written informed consent.
Exclusion Criteria:
- Rescue angioplasty after failed thrombolysis;
- Stent thrombosis;
- Culprit lesion located in a bypass graft or in the left main trunk;
- Cardiogenic shock;
- Young age (< 18 years);
- Severe renal failure (creatinine clearance ≤30 ml/min);
- Concomitant disease resulting in a life expectancy of less than 6 months;
- Pregnancy;
- Contraindications to contrast agents not manageable medically, or to study medications, including aspirin, clopidogrel, ticlopidine and heparin;
- Left bundle branch block, paced rhythm, frequent ventricular ectopy, pre-excitation or other ECG abnormalities interfering with the analysis of ST-segment resolution;
- Markedly depressed LV function (LVEF <30%); Culprit lesion cannot be identified;
- Severe left main or triple vessel disease requiring CABG during the index hospitalization;
- Patients already involved in other ongoing trials;
- Patients unable or unwilling to give their informed consent.
Sites / Locations
- Dipartimento Medicina CardiovascolareRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Excimer laser
Manual Thrombus Aspiration
After wire crossing, Excimer Laser will be performed. Consequently, intracoronary adenosine will be selectively administered through the guiding catheter.
After wire crossing, thrombus aspiration will be performed. The device will removed outside the body, flushed with saline and subsequently reintroduced in the culprit vessel beyond the occlusion site and intracoronary adenosine will be selectively administered.