Landmark Research Studies

Two large trials, prior to the TOTAL study, had reported contradictory results at one year after thrombus aspiration in ST elevation myocardial infarction (STEMI). In a one-year follow-up of the largest randomised trial of thrombus aspiration, we aimed to clarify the longer-term benefits, to help guide clinical practice.

The objective of the TOTAL study was to determine if aspiration thrombectomy can reduce the rate of cardiovascular death, re-infarction, cardiogenic shock or new or worsening NYHA Class IV heart failure up to 180 days, in patients with STEMI undergoing primary PCI.

TOTAL was a randomized, unblinded treatment with outcomes adjudicated by assessors who will be blinded to the treatment arm.

We found that routine thrombus aspiration during PCI for STEMI did not reduce longer-term clinical outcomes and might be associated with an increase in stroke. As a result, thrombus aspiration can no longer be recommended as a routine strategy in STEMI.

Study Type

Interventional - Device

Study Design

Randomized trial

NO. of Countries


NO. of Sites


NO. of Participants


Study Period

2010 - 2015



VIDEO: Sanjit Jolly on TOTAL study, at ACC 2016

Canadian Institutes of Health Research (CIHR)


PHRI grant

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