Twenty-one RCTs (3,721 patients) were included.
Postprocedural TIMI flow (21 studies, 3,664 patients).
Adjunctive devices showed increased rates compared with controls (OR 1.34, 95% CI: 1.02, 1.76, p=0.03). There was moderate evidence of heterogeneity (p=0.11). Estimates were similar for thrombectomy and distal protection devices. There was no evidence of publication bias (p=0.75).
Postprocedural MBG 3 perfusion (15 studies, 2,644 patients).
Adjunctive devices showed increased rates compared with controls (OR 2.21, 95% CI: 1.48, 3.32, p<0.0001). There was strong evidence of heterogeneity (p<0.0001). Estimates were similar for thrombectomy and distal protection devices.
Distal embolisation (14 studies, 3,036 patients).
Adjunctive devices showed decreased embolisation compared with controls (OR 0.58, 95% CI: 0.39, 0.87, p=0.008). There was strong evidence of heterogeneity (p=0.04). Thrombectomy catheters were more effective than distal protection devices, although this association was not statistically significant.
Mortality at 30 days (18 studies, 3,472 patients).
Adjunctive devices did not affect mortality (OR 0.97, 95% CI: 0.64, 1.46, p=0.88). There was no evidence of heterogeneity (p=0.88).
Device safety (number of studies not reported, 2,923 patients).
There were no differences in safety (numbers of coronary perforations) between adjunctive devices and control groups (OR 3.05, 95% CI: 0.48, 19.40, p=0.24). There was no evidence of heterogeneity (p=0.63).