MYOCARDIAL REPERFUSION IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN THE USE OF MANUAL THROMBUS ASPIRATION

Objective: to determine the efficiency and safety of manual thrombus aspiration (TA) in patients with acute ST-segment elevation myocardial infarction.Material and methods. The investigation enrolled 200 patients with ST-segment elevation myocardial infarction. According to prehospital therapy, all...

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Main Authors: A. S. Tereshchenko, G. K. Arutyunyan, E. V. Merkulov, D. M. Kayraliev, A. E. Grossman, A. N. Samko
Format: Article
Language:English
Published: Luchevaya Diagnostika, LLC 2018-03-01
Series:Вестник рентгенологии и радиологии
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Online Access:https://www.russianradiology.ru/jour/article/view/216
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author A. S. Tereshchenko
G. K. Arutyunyan
E. V. Merkulov
D. M. Kayraliev
A. E. Grossman
A. N. Samko
author_facet A. S. Tereshchenko
G. K. Arutyunyan
E. V. Merkulov
D. M. Kayraliev
A. E. Grossman
A. N. Samko
author_sort A. S. Tereshchenko
collection DOAJ
description Objective: to determine the efficiency and safety of manual thrombus aspiration (TA) in patients with acute ST-segment elevation myocardial infarction.Material and methods. The investigation enrolled 200 patients with ST-segment elevation myocardial infarction. According to prehospital therapy, all the patients were divided into life-saving (n = 100) percutaneous coronary intervention (PCI) (lsPCI) and primary (n = 100) PCI (pPCI) groups. After coronary angiography the patients were randomized into manual TA (n = 50) and non-manual TA (n = 50) groups. The endpoints took into consideration myocardial reperfusion and the impact of TA on immediate results and in-hospital prognosis.Results. The pPCI subgroup with TA as compared to the non-TA subgroup more commonly achieved TIMI-3 flow (82 and 54%, respectively; p = 0.003) and myocardial blush grade 3 or 4 (60 and 36%, respectively, p = 0.016). ECG also showed the achievement of the indirect signs of infarct-related artery reperfusion (pPCI + TA, 44%; and pPCI – TA, 76%; p = 0.001). On the contrary, in the lsPCI group, the best antegrade blood flow was recorded in the non-manual TA patients, as shown by both the TIMI scale (48 and 70%, respectively; p = 0.025) and the myocardial blush grade (24 and 50%, respectively, p=0,007). A larger number of patients from the non-TA subgroup were noted to have a decrease in the ST segment, as evidenced by ECG (slPCI + TA, 34% and slPCI – TA, 54%; p = 0.044).Conclusion. According to angiographic and electrocardiographic findings, coronary blood flow effectively restored in the pPCI + TA group while manual TA did not show any advantages over routine PCI in the slPCI group.
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series Вестник рентгенологии и радиологии
spelling doaj-art-555ab245e782402584dc0ea1de7cff5a2025-08-20T03:08:59ZengLuchevaya Diagnostika, LLCВестник рентгенологии и радиологии0042-46762619-04782018-03-01991232910.20862/0042-4676-2018-99-1-23-29212MYOCARDIAL REPERFUSION IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN THE USE OF MANUAL THROMBUS ASPIRATIONA. S. Tereshchenko0G. K. Arutyunyan1E. V. Merkulov2D. M. Kayraliev3A. E. Grossman4A. N. Samko5National Medical Research Center of Cardiology, Ministry of Health of the Russian FederationNational Medical Research Center of Cardiology, Ministry of Health of the Russian FederationNational Medical Research Center of Cardiology, Ministry of Health of the Russian FederationNational Medical Research Center of Cardiology, Ministry of Health of the Russian FederationNational Medical Research Center of Cardiology, Ministry of Health of the Russian FederationNational Medical Research Center of Cardiology, Ministry of Health of the Russian FederationObjective: to determine the efficiency and safety of manual thrombus aspiration (TA) in patients with acute ST-segment elevation myocardial infarction.Material and methods. The investigation enrolled 200 patients with ST-segment elevation myocardial infarction. According to prehospital therapy, all the patients were divided into life-saving (n = 100) percutaneous coronary intervention (PCI) (lsPCI) and primary (n = 100) PCI (pPCI) groups. After coronary angiography the patients were randomized into manual TA (n = 50) and non-manual TA (n = 50) groups. The endpoints took into consideration myocardial reperfusion and the impact of TA on immediate results and in-hospital prognosis.Results. The pPCI subgroup with TA as compared to the non-TA subgroup more commonly achieved TIMI-3 flow (82 and 54%, respectively; p = 0.003) and myocardial blush grade 3 or 4 (60 and 36%, respectively, p = 0.016). ECG also showed the achievement of the indirect signs of infarct-related artery reperfusion (pPCI + TA, 44%; and pPCI – TA, 76%; p = 0.001). On the contrary, in the lsPCI group, the best antegrade blood flow was recorded in the non-manual TA patients, as shown by both the TIMI scale (48 and 70%, respectively; p = 0.025) and the myocardial blush grade (24 and 50%, respectively, p=0,007). A larger number of patients from the non-TA subgroup were noted to have a decrease in the ST segment, as evidenced by ECG (slPCI + TA, 34% and slPCI – TA, 54%; p = 0.044).Conclusion. According to angiographic and electrocardiographic findings, coronary blood flow effectively restored in the pPCI + TA group while manual TA did not show any advantages over routine PCI in the slPCI group.https://www.russianradiology.ru/jour/article/view/216myocardial infarctionpercutaneous coronary interventionmanual thrombus aspirationmyocardial reperfusion
spellingShingle A. S. Tereshchenko
G. K. Arutyunyan
E. V. Merkulov
D. M. Kayraliev
A. E. Grossman
A. N. Samko
MYOCARDIAL REPERFUSION IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN THE USE OF MANUAL THROMBUS ASPIRATION
Вестник рентгенологии и радиологии
myocardial infarction
percutaneous coronary intervention
manual thrombus aspiration
myocardial reperfusion
title MYOCARDIAL REPERFUSION IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN THE USE OF MANUAL THROMBUS ASPIRATION
title_full MYOCARDIAL REPERFUSION IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN THE USE OF MANUAL THROMBUS ASPIRATION
title_fullStr MYOCARDIAL REPERFUSION IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN THE USE OF MANUAL THROMBUS ASPIRATION
title_full_unstemmed MYOCARDIAL REPERFUSION IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN THE USE OF MANUAL THROMBUS ASPIRATION
title_short MYOCARDIAL REPERFUSION IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN THE USE OF MANUAL THROMBUS ASPIRATION
title_sort myocardial reperfusion in patients with acute st segment elevation myocardial infarction in the use of manual thrombus aspiration
topic myocardial infarction
percutaneous coronary intervention
manual thrombus aspiration
myocardial reperfusion
url https://www.russianradiology.ru/jour/article/view/216
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