Intracoronary aspiration thrombectomy for acute myocardial infarction
Intracoronary aspiration thrombectomy for acute myocardial infarction
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DOI：
10.1016/s0002-9149(98)00489-5
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发表时间：
1998-10-01
影响因子：
2.8
通讯作者：
Ohnaka, M
中科院分区：
文献类型：
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作者：
Murakami, T;Mizuno, S;Ohnaka, M
为了探讨急性心肌梗死(AMI)的发病机制和冠状动脉内抽吸取栓(ICAT)的价值，我们将ICAT应用于再灌注治疗，使用普遍存在的冠状动脉内导管抽吸冠状动脉内闭塞组织。我们将ICAT或直接经皮冠状动脉腔内成形术(PTCA)分配给进展期急性心肌梗死(心肌梗死溶栓(TIMI)试验0级)患者，并调查了43例单独接受ICAT或随后接受PTCA治疗的患者的主要组织病理学、临床和血管造影结果，并与48例接受直接PTCA治疗的患者进行了比较。未发生重大并发症(程序性死亡、紧急搭桥手术)。25例(58%)单纯ICAT患者和39例(91%)ICAT或PTCA术后患者实现了再通(TlMI分级3级和2级)。抽吸血栓为近期血栓21例(49%)，动脉粥样硬化6例(14%)，无血栓13例(30%)，机化血栓1例。在近期血栓形成的病例中，单用ICAT的再通率高于动脉粥样斑块或无血栓的患者(分别为18/21[86%]、3/6[50%]、4/13[31%]；p
To investigate the pathogenesis of acute myocardial infarction (AMI) and values of intracoronary aspiration thrombectomy (ICAT), we applied ICAT to reperfusion therapy using generally available intracoronary catheters to aspirate intracoronary occlusive tissues. We assigned ICAT or primary percutaneous transluminal coronary angioplasty (PTCA) to patients with evolving AMI (Thrombolysis In Myocardial Infarction (TIMI) trial grade 0), and investigated primary histopathologic, clinical, and angiographic outcomes in 43 patients treated with ICAT alone or followed by PTCA, and compared the outcomes with those in 48 patients treated with primary PTCA. No major complications (procedural death, emergent bypass graft surgery) occurred. Recanalization (TlMI grade 3 and 2) was achieved in 25 patients (58%) with ICAT alone and in 39 patients (91%) with ICAT alone or followed by PTCA. Aspirated thrombi were defined as recent thrombi in 21 cases (49%), atheroma in 6 (14%), no thrombi in 13 (30%), and organized thrombi in 1 case. In cases of recent thrombi, ICAT alone provided recanalization more frequently than in those of atheroma or no thrombi (18 of 21 [86%], 3 of 6 [50%], 4 of 13 [31%], respectively; p