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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Luchevaya Diagnostika, LLC
2018-03-01
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| 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. |
| format | Article |
| id | doaj-art-555ab245e782402584dc0ea1de7cff5a |
| institution | DOAJ |
| issn | 0042-4676 2619-0478 |
| language | English |
| publishDate | 2018-03-01 |
| publisher | Luchevaya Diagnostika, LLC |
| record_format | Article |
| 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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