| ObjectiveThrombus aspiration has been highly praised by clinicians and patients since its advent.Large-scale randomized controlled studies have shown that conventional thrombus aspiration during emergency PCI has limited effect on improving the prognosis of patients with acute myocardial infarction.It can be seen that the prognosis of patients with thrombus aspiration needs to be improved in clinical work.The purpose of this study was to investigate whether thrombus aspiration and thrombus aspiration should be performed in patients with acute ST-segment elevation myocardial infarction(STIMI)during emergency PCI.Method506 patients with acute ST-segment elevation myocardial infarction who underwent emergency percutaneous coronary intervention(PCI)in our hospital were retrospectively analyzed.According to whether thrombus aspiration was performed directly after the beginning of coronary angiography,the patients in the aspiration group were divided into two groups:A.The patients in the aspiration group were those who underwent thrombus aspiration directly;B.the patients in the control group were those who underwent thrombus aspiration without thrombus aspiration or remedial thrombus aspiration after balloon dilatation or stent implantation.At the same time,the patients who underwent thrombus aspiration after balloon dilatation or stent implantation were defined as the remedial thrombus aspiration group.The intraoperative stent implantation and balloon usage in each group were compared and analyzed.Length of stent implantation,operation time,TIMI blood flow,adjuvant medication,left ventricular ejection fraction(LVEF),mortality during hospitalization and incidence of other related adverse cardiac events.ResultThere were no significant differences in sex,age,hypertension,diabetes mellitus,cerebral infarction,smoking,drinking,oral medication before operation,degree of intraoperative vascular lesions,and application of low molecular weight heparin after operation between the experimental group and the control group.However,there were significant differences in the use of tirofiban after surgery.There were no significant differences in the number of stents used,the length of stents implanted and the TIMI blood flow classification between the experimental group and the control group,but there were significant differences in the number of balloons used and the operation time.There was statistical difference in TIMI blood flow(P=0.003)before and after aspiration in the remedial aspiration group.In terms of prognosis,4.86% of patients in the control group died(16:329)and 3.95% of patients in the experimental group died(7:177)(OR value was 0.803,95% confidence interval was CI,0.324 to 1.990,P=0.635).There was no significant difference in mortality between the two groups.The incidence of complications [hypotension(11.29% VS 12.46%,P = 0.700),arrhythmia(8.47% VS 5.47%,P = 0.192)] and left ventricular ejection fraction(P = 0.078)were not significantly different between the two groups.The blood flow of 16 patients with remedial thrombus aspiration [thrombus score M(Q1,Q2)was 4.00(3.00,4.00)] before and after aspiration showed that the blood flow was significantly improved after aspiration(P=0.003).There were no significant differences in mortality,incidence of hypotension,incidence of arrhythmia and postoperative LVEF between the remedial aspiration group and the experimental group.Conclusion1.There is no significant difference in short-term prognosis and mortality between patients with acute ST-segment elevation myocardial infarction treated with routine thrombus aspiration and those without temporary thrombus aspiration when needed.On the contrary,the operation time of patients with acute ST-segment elevation myocardial infarction is prolonged to a certain extent,which may be unfavorable to the rapid opening of criminals’ blood vessels.2.Thrombosuction as a remedy may improve the blood flow of criminals’ blood vessels and may become a reasonable remedy for the poor effect of balloon dilation. |
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