Table 241Strength of applicability for the body of evidence evaluating no reflow in patients with acute coronary syndromes

ComparisonStrength of ApplicabilityConclusion with Description of Applicability
Catheter aspiration devices versus controlLowCompared with control, patients who undergo native vessel PCI with a catheter aspiration device have a decreased risk of no reflow. Overall applicability is limited because all studies were conducted outside of the US and almost half of the data is derived from studies which evaluate devices that are not currently available in the US. Data is highly applicable to male patients with STEMI undergoing primary PCI and moderately applicable to female patients. Data has low applicability in patients undergoing rescue PCI and is not applicable in patients with other ACS.
Catheter aspiration versus distal balloon embolic protection deviceLowCompared to the catheter aspiration device Diver CE, patients undergoing native vessel PCI with the distal balloon embolic protection device Guardwire Plus do not have a difference in the risk of no reflow. Overall data is limited because the Diver CE device is not currently available in the US. Data is highly applicable to Asian male patients with STEMI undergoing primary PCI on the right coronary artery.
Mechanical thrombectomy devices versus controlModerateCompared with control, patients who undergo native vessel PCI with a mechanical thrombectomy device do not have a difference in the risk of no reflow. Overall the data has limited applicability because the majority of studies were conducted outside of the US. Data is highly applicable to male patients with STEMI and moderately applicable in female patients. Data has low applicability in patients undergoing rescue PCI and is not applicable to patients with other ACS.
Distal filter embolic protection devices versus controlLowCompared with control, patients who undergo native vessel PCI with a distal filter embolic protection device do not have a difference in the risk of no reflow. Overall data is limited because all studies were conducted outside of the US and the majority of data is derived from studies which evaluated a device that is not currently available in the US. Data is applicable to patients with ACS undergoing primary PCI.
Distal balloon embolic protection devices versus controlModerateCompared with control, patients who undergo native vessel PCI with a distal balloon embolic protection device do not have a difference in the risk of no reflow. Overall applicability is limited because a majority of studies were conducted outside of the US. Data is highly applicable to male patients with STEMI undergoing primary PCI. Data is moderately applicable to female patients and has low applicability to patients with other ACS or undergoing rescue PCI.
Embolic protection devices combined versus controlModerateCompared with control, patients who undergo native vessel PCI with an embolic protection device do not have a difference in the risk of no reflow. Applicability of the data is limited because a majority of the studies were conducted outside of the US. Data is highly applicable to male patients with STEMI undergoing primary PCI and moderately applicable to female patients. The data has low applicability in patients with other ACS or undergoing rescue PCI

Abbreviations: ACS=Acute coronary syndrome; PCI=Percutaneous coronary intervention; STEMI=ST-segment elevation myocardial infarction; US=United States; Y=Years

From: Appendix H, Applicability of Individual Studies and of the Body of Evidence

Cover of Adjunctive Devices for Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
Adjunctive Devices for Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention [Internet].
Comparative Effectiveness Reviews, No. 42.
Sobieraj DM, White CM, Kluger J, et al.

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