【摘要】 目的单中心前瞻性随机比较急性下壁心肌梗死(AIMI)患者施行 PCI 前应用Guardwire Plus 与 Diver CE 两种血栓去除装置的效果。方法采用单中心前瞻性随机方法比较发病<12 h、TIMI 血流0～1级 AIMI 患者施行直接 PCI 前应用 Guardwire Plus 与 Diver CE 两种血栓去除装置的有效性。主要终点是 PCI 后1 h 内 ST 段回落程度。结果 122例患者人选本研究。Diver CE 组和 Guardwire Plus 组的年龄[(59.6±14)岁比(60.1±13)岁]、男性(82%比84%)、糖尿病(31%比28%)、既往冠心病(25%比23%)、症状发作到直接 PCI 时间[(550±185)rain比(345±180)min]和应用血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂(11%比13%)等基线资料均匹配。两组 ST 段回落(70%)率(57%比59%)、慢血流和无再流发生率(8%比7%)、TIMI 血流3级率(95%比97%)和心肌染色血流3级率(70%比72%)差异均无统计学意义(P>0.05)。术后1个月临床结果显示,左心室射血分数[(0.54±0.12)比(0.53±0.11)]、死亡(3%比3%)、再次心肌梗死(2%比0)和靶血管重建(2%比2%)差异也无统计学意义(P>0.05)。结论与 Guardwire Plus 装置比较,在 AIMI 患者施行支架术前应用 Diver CE 装置去除血栓,同样可以降低远端栓塞、促进 ST 段回落并改善心肌灌注。更多还原

【Abstract】 Objective In this randomized prospective single-center study,we compared the efficacy of adjunctive thrombectomy using Diver CE device(Invatec,Italy)versus Guardwire Plus device (Medtronic,USA)before percutaneous coronary intervention(PCI)in patients with <12 h acute inferior myocardial infarction(AIMI)and Thrombolysis In Myocardial Infarction(TIMI)flow grade 0 to 1.The primary end point was the magnitude of ST-segment resolution after PCI.Methods A total of 122 patients (61 in Diver CE group and 61 in Guardwire Plus group)were studied.The magnitude of ST-segment resolution,myocardial blush grade and slow flow or no re-flow 1 h after PCI were measured in study patients. Results Baseline characteristics were similar between groups:age(59.6±14 years vs.60.1±13 years), males(82% vs.84%),diabetes(31% vs.28%),previous coronary artery disease(25% vs.23%), onset-to-angiogram(350±185 min vs.345±180 min),and glycoprotein Ⅱb/Ⅲa inhibitor use(11% vs. 13%,all P>0.05).The magnitude of ST-segment resolution was also similar in these two groups:ST- segment resolution >70%(57% vs.59%,P>0.05).Slow flow/no reflow rate(8% vs.7%),TIMI flow grade 3(95% vs.97%)and myocardial blush grade 3(70% vs.72%)post PCI were not different in the groups(all P>0.05).Left ventricle ejection fraction(0.54±0.12 vs.0.53±0.11),death(3% vs. 3%),re-myocardial infarction(2% vs.0)and target vessel revascularization(2% vs.2%)at one month post PCI were comparable(all P>0.05).Conclusion Efficacy of removing thrombus burden with Diver CE device or Guardwire Plus device was similar in patients with <12 h acute inferior myocardial infarction.更多还原