Comparing two methods for treating blood clots during heart procedures

A Randomized Trial of Intrathrombus Thrombolysis Versus Aspiration Thrombectomy During Primary Percutaneous Coronary Intervention in ST-segment Elevation Myocardial Infarction Patients With High Thrombus Burden

Not applicable Interventional China-Japan Friendship Hospital · NCT05554588

This study is testing two different ways to remove blood clots during heart procedures to see which one helps people with heart attacks do better over the next year.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment2500 (estimated)
Ages18 Years to 80 Years
SexAll
SponsorChina-Japan Friendship Hospital Academic / other
Locations1 site (Beijing, Beijing Municipality)
Trial IDNCT05554588 on ClinicalTrials.gov

What this trial studies

This multicenter, randomized, controlled trial investigates the effectiveness of intrathrombus thrombolysis versus manual aspiration thrombectomy in patients with ST-Segment Elevation Myocardial Infarction (STEMI) and high thrombus burden undergoing primary percutaneous coronary intervention (PPCI). Participants will be assigned to one of the two treatment methods to evaluate which approach better reduces major adverse cardiovascular events over a one-year period. The study aims to provide insights into optimal treatment strategies for patients with significant blood clots during heart attacks.

Who should consider this trial

Good fit: Ideal candidates are STEMI patients with high thrombus burden presenting within 12 hours of symptom onset or 12-24 hours with persistent symptoms.

Not a fit: Patients who have undergone previous coronary artery bypass grafting (CABG) or have a life expectancy of less than one year may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to improved outcomes and reduced complications for patients experiencing severe heart attacks.

How similar studies have performed: Other studies have explored similar interventions, but this specific comparison of intrathrombus thrombolysis and aspiration thrombectomy in high thrombus burden STEMI patients is relatively novel.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

1. Patients presenting with:

   * Symptoms of myocardial ischemia lasting for ≥ 30 minutes AND
   * Definite ECG changes indicating STEMI: ST elevation of greater than 0.1 mV in two contiguous limb leads or 0.2 mV in two contiguous precordial leads
2. Referred for PPCI
3. Within 12 hours of symptom onset, or 12-24 hours but still suffered from persistent symptom, hemodynamic instability or fatal arrhythmia
4. High thrombus burden:

   * TIMI thrombus grade 3 or 4 after emergency coronary angiography
   * Or TIMI thrombus grade ≥3 after guidewire crossing or 1.5mm-diameter predilating the culprit lesion if emergency coronary angiography shows TIMI thrombus grade 5
5. Informed consent

Exclusion Criteria:

1. Rescue PCI after systemic thrombolysis
2. Previous CABG history
3. Life expectancy\<1 year
4. Active bleeding in past 6 months, hemorrhagic disorders and prone to bleeding
5. Serious hepatic or kidney dysfunction
6. Pregnancy and lactation
7. Uncontrolled hypertension (\>180/100mmHg)
8. Previous hemorrhagic stroke or ischemic stroke in past 3 months
9. Cardiogenic shock or cardio-pulmonary resuscitation
10. Informed consent cannot be obtained or follow-up cannot be completed

Where this trial is running

Beijing, Beijing Municipality

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Acute Coronary SyndromeST Elevation Myocardial InfarctionPercutaneous Coronary Intervention
Last reviewed 2026-06-15 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.