Effect Of Transcatheter Aspiration Of Coronary Thrombus In Patients With Acute Myocardial Infarction

Objective:We introduced the effect of transcatheter aspiration of coronary thrombus before the stent implanted during emergency PCI in acute myocardial infarction patients.Methods:AMI patients with intra coronary thrombus were selected.The patients were divided into tow group:PT+PCI(n=14)and PCI(n=21).In the PCI group stents were directly implanted or after PTCA stent were directly implanted.In the PT+PCI group we used the common coronary wire across the lesion after guiding catheter to the ostium of coronary arteries.Aspiration catheter(DIVER C.E.)was directly advanced over the wire to the lesion and aspirated the thrombus. After thrombus disappeared,stent were directly implanted or after PTCA stent were directly implanted.Comparing the differents of the epicardial flow,tissue-level perfusion flow and the rate of descendent level of ST-segment.Comparing the amounts of stent implanted in the two groups.Results:35 cases of AMI patients with intra coronary thrombus received the PCI or PT+PCI treatment.In the PT+PCI group,the coronary re-opened and thrombus disappeared after aspiration.In the PT+PCI group, the epicardial flow TIMI(2.96±0.13 vs 2.64±0.64,u=83.5,p=0.031),CTFC(19.4±6.61vs27.9±13.3,u=71.5,p=0.010),the tissue-level perfusion flow TMP(2.54±0.57vs1.90±0.54,u=87,p=0.044)and the rate of descendent level of ST-segment(71%vs33%,x~2=4.88,P=0.030)were all superior to the PCI group,it indicate that transcatheter aspiration of coronary thrombus before the stent implanted can improve AMI patient's tissue-level perfusion.The rate of directly stent implanted (57%vs24%,x~2=4.00,P=0.045)were also superior to the PCI group,it indicate that transcatheter aspiration of coronary thrombus before the stent implanted can decrease the PTCA before the stent implanted.The amounts of stent implanted had not different betwent the two groups(1.29±0.61vs1.14±0.36,u=135,p=0.702).Conclusion: Transcatheter aspiration of coronary thrombus before the stent implanted is a simple and effective method to manage the acute myocardial infarction patients with intra coronary thrombus.It maybe can improve AMI patient's tissue-level perfusion.