A trial comparing rheolytic thrombectomy with intracoronary urokinase for coronary and vein graft thrombus (The Vein Graft AngioJet Study [VeGAS 2])

In the Vein Graft AngioJet Study (VeGAS 2), patients with angiographic thrombus were randomized to undergo either standard intracoronary/graft urokinase infusion (n = 169) or AngioJet rheolytic thrombectomy (n = 180), followed by definitive treatment. Both treatments were equally effective with respect to the primary composite end point of major adverse cardiac events (occurrence of death, Q-wave myocardial infarction, emergent coronary bypass surgery, target lesion revascularization, stroke, or stent thrombosis) by 30 days, failure to achieve postprocedure diameter stenosis <50%, failure to achieve postprocedure Thrombolysis In Myocardial Infarction (TMI) 3 flow, or failure to achieve ≥20% change in diameter stenosis. AngioJet had significantly higher procedure success, lower 30-day major adverse cardiac events, and fewer vascular complications.