Clinical utility of thrombus aspiration using the Hunter catheter in patients with acute myocardial infarction: the Hunted registry.

INTRODUCTION AND OBJECTIVES: Manual thrombectomy (MT) during primary percutaneous coronary intervention (PCI) aims to reduce thrombus burden. Our study evaluates the outcomes and predictors of successful MT. METHODS: The Hunted registry is a retrospective, single-center cohort study including patients who underwent MT during PCI using the Hunter catheter from July 2020 through February 2022. MT success was defined as an angiographic reduction to a Thrombolysis in Myocardial Infarction (TIMI) thrombus grade of ≤ 2, with clinical follow-up for major adverse cardiovascular events. RESULTS: Among 750 patients with acute myocardial infarction who underwent PCI, 401 (53%) received MT. The mean age of treated patients was 62 years (80% men). MT was effective in 327 patients (81.55%). Predictors of successful MT included larger vessel diameter (P < .001), high thrombus burden (TIMI grade ≥ 4 flow; P < .001), and non-circumflex target vessels (P < .001). Device-related complications occurred in 17 patients (4.3%). At follow-up, major adverse events occurred in 8.98% of patients at 1 year and in 9.97% at 2 years. CONCLUSIONS: In patients with ST-segment elevation myocardial infarction undergoing PCI, MT with the Hunter catheter in selected cases with high thrombus burden (TIMI grade ≥ 4 flow), non-circumflex target vessels, and vessel diameters > 2.5 mm, is a safe and effective technique with a low rate of complications.