Table 1.
Summary of studies investigating intracoronary thrombolysis for patients with STEMI
Study | Year | No of patients (N) | Treatment arms | Route of delivery | Timing of delivery | P2Y12 inhibitor | GPIIb/IIIa inhibitor (%) | Unfractionated heparin | Thrombus aspiration (%) | Follow-up |
Sezer et al 25 | 2009 | 95 |
|
Guide catheter | Post-stent | Clopidogrel |
|
100 U/kg | NR | 6 months |
Zhao et al 18 | 2015 | 183 |
|
Micro-catheter | Post-thrombus aspiration, pre-stent | Clopidogrel | NR | 8000–9000 U (additional 1000 U every 1 hour as required) | NR | 30 days |
Greco et al 29 | 2013 | 102 |
|
Micro-catheter | Pre-stent | Clopidogrel | NR | 100 U/kg | NR | 6 months |
Geng et al 20 | 2018 | 230 |
|
Punctured balloon catheter | Post-balloon, pre-stent | Ticagrelor | NR | 3000 U+70 U/kg for PCI | NR | 6 months |
Xiao et al 28 | 2019 | 71 |
|
Micro-catheter | Post-balloon, pre-stent | Ticagrelor |
|
50–70 U/kg |
|
12 months |
Fu et al 19 | 2019 | 39 |
|
Micro-catheter, child-in-mother catheter or pierced balloon | Pre-stent | Clopidogrel/ticagrelor | NR | NR |
|
90 days |
McCartney et al 24 | 2019 | 440 |
|
Aspiration catheter or guide catheter if selectively engaged | Post-balloon, pre-stent | Clopidogrel/ticagrelor/prasugrel |
|
10 000 U |
|
3 months |
Gibson et al 21 | 2020 | 36 |
|
Balloon catheter | 1st dose: pre-balloon; 2nd dose: post-stent | Clopidogrel |
|
70 U/kg | NR | 30 days |
Wang et al 26 | 2020 | 182 |
|
Aspiration catheter | Post-thrombus aspiration, pre-stent | Ticagrelor |
|
3000 U (additional dosage by ACT) |
|
6 months |
Wu et al 27 | 2020 | 50 |
|
Aspiration catheter | Post-thrombus aspiration, pre-stent | Ticagrelor |
|
5000 U (additional dosage guided by ACT) |
|
3 months |
Huang et al 22 | 2021 | 345 |
|
Intracoronary catheter | Post-balloon or thrombus aspiration; pre-stent | Clopidogrel/ticagrelor |
|
70–100 U/kg |
|
30 days |
Jiang et al 23 | 2021 | 260 |
|
Balloon catheter | Post-balloon, pre-stent | Ticagrelor | NR | 100 U/kg |
|
6 months |
ACT, activated clotting time; GPIIb/IIIa, glycoprotein IIb/IIIa; NR, not reported; PCI, percutaneous coronary intervention; STEMI, ST-elevation myocardial infarction.