新型血栓抽吸装置DIVER^（TM）CE导管在急诊PCI中的应用

Application of a new type of percutaneous thrombectomy device DIVER^（TM）CE catheter in primary percutaneous coronary intervention for acute myocardial infarction

目的评估采用一种新型血栓抽吸（PT）装置DIVER^TMCE导管在急性心肌梗死（AMI）经皮冠状动脉介入治疗（PCI）中的可行性、安全性及有效性。方法发病12h内的AMI病人42例,均行急诊PCI治疗,其中单纯PCI组23例,PCI＋PT组19例,比较两组术后冠脉血流灌注水平（TIMI分级）、心肌血流灌注水平（TMP分级）及30d的主要不良心脏事件（MACE）。结果PCI＋PT组术后平均罪犯血管TIMI血流恢复至（2.74±0.56）级,明显优于单纯PCI组[（2.30±0.63）级,P〈0.05];PCI＋PT组心肌灌注TMP分级（2.53±0.61）级,明显优于单纯PCI组[（2.13±0.55）级,P〈0.05];30d内的MACE发生率两组间无显著性差异。结论在AMI患者急诊PCI治疗中运用血栓抽吸装置DIVERTMCE导管是安全、有效的,其疗效明显优于单纯PCI术。

To evaluate the feasibility,safety and efficacy of percutaneous thrombectomy（PT）with DIVER^TMCE catheter in the primary percutaneous coronary interventional therapy（PCI）of acute myocardial infarction（AMI）.Methods Fourty-two patients with AMI 12 h after onset were divided into standard PCI group（n=23）and PCI combined with PT group（n=19）.Coronary reperfusion flow（TIMI grades）,TIMI myocardial perfusion（TMP grades）,and major adverse cardiac events（MACE）within 30 days after the setting of AMI were calculated.Results The average TIMI reperfusion grades and TMP grades of culprit coronary artery in PCI＋PT group were higher than those in PCI group（2.74±0.56 and 2.53±0.61 vs 2.30±0.63 and 2.13±0.63,respectively）.No difference was found about MACE between two groups 30 days after onset.Conclusion The DIVERTMCE device is an intuitive,fast,safe,and effective alternative for the patients with AMI,which is better than pure PCI alone.