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目的评价急性ST段抬高心肌梗死(STEMI)患者急诊冠状动脉介入治疗(PCI)中应用血栓抽吸装置的效果与安全性。方法入选50例患者,将Diver CE血栓抽吸导管送至闭塞病变血栓前,将其尾端的注射器抽成负压状态,前后移动抽吸导管,从近端至远端尽可能深地进行抽吸。结果冠脉造影均提示大量血栓征象,抽吸后梗死相关血管血栓负荷明显降低,36例可见红色血栓,42例即刻恢复TIMIⅢ级血流,8例恢复TIMIⅡ级血流。均行支架治疗,术后前向血流均达到TIMIⅢ级,血管开通率100%。结论 PCI中应用Diver CE血栓抽吸装置在血栓负荷较重的AMI患者中能有效地减少梗死相关血管内的血栓负荷及远端栓塞,显著改善患者术后即刻的远端心肌血流灌注,应用Diver CE血栓抽吸导管安全可行。
Objective To evaluate the efficacy and safety of thrombus aspiration in acute coronary intervention (PCI) with acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 50 patients were enrolled. The Diver CE thrombus aspiration catheter was delivered to the anterior occlusion thrombus, the negative end of the syringe was evacuated, the aspiration catheter was moved back and forth, and the aspiration was as deep as possible from the proximal end to the distal end . Results Coronary angiography showed a large number of thrombus signs. The load of infarct-related vascular thrombus was significantly decreased after aspiration. Thrombus was seen in 36 cases, TIMI grade Ⅲ was restored in 42 cases and TIMI Ⅱ level in 8 cases. All patients underwent stent treatment. The antegrade blood flow reached TIMI grade Ⅲ and the rate of vascular opening was 100%. Conclusion The application of Diver CE thrombus aspiration device in PCI can effectively reduce infarction-related intravascular thrombosis and distal embolism in AMI patients with severe thrombus loading and significantly improve immediate postoperative immediate myocardial perfusion. Diver CE Thrombus aspiration catheter is safe and feasible.