ZEEK血栓抽吸导管在急性心肌梗死直接PCI中应用的安全性和有效性

The efficiency and safety of the Zeek aspiration thrombectomy catheter in primary percutaneous coronary intervention of acute myocardial infarction(AMI)

目的评价急性心肌梗死急诊经皮冠状动脉介入治疗(PCI)中应用ZEEK血栓抽吸导管对改善心肌组织灌注及临床预后的作用。方法选择2007年3月至2008年5月符合急诊PCI治疗条件的急性心肌梗死患者共86例,其中使用ZEEK血栓抽吸导管42例患者作为血栓抽吸组,未使用ZEEK血栓抽吸导管44例患者作为对照组,比较两组间的基础资料、造影结果和临床预后。结果两组冠状动脉造影显示的血管开通率均为100%,血栓抽吸组ST段抬高回落百分比、心肌呈色分级的结果均明显优于对照组(68.69%±11.62%比45.54%±10.76%;78.57%比54.54%,P均<0.05),术后3个月心脏不良事件发生率与对照组相当。结论在急性心肌梗死急诊PCI中应用ZEEK血栓抽吸导管安全可行,有效的清除冠状动脉内血栓,改善心肌组织灌注,有可能改善术后心脏功能,并且不增加主要心脏不良事件的发生率。

Objective To assess the effect of the Zeek aspiration thrombectomy catheter in improving the myocardial reperfusion and clinical prognosis in patients with acute myocardial infarction（AMI） who were undergone primary pereutaneous coronary intervention （PCI）. Methods From Mar 2007 to May 2008, a total of 86 patients with STEMI undregoing primary PCI treatment were enrolled in this study, and Zeek aspiration thrombectomy catheters were used in 42 cases of them. The baseline characteristics, angiographic results and clinical prognosis were compared between the two groups. Results The vessel repass rate was 100% in these two groups. The ST segment resolution and TMP grades were signifi-cantly improved in Zeek group（68.69%±11.62%vs.45.54%±10.76%;P〈0.05;78.57%vs.54.54%,P〈0.05）. The incidence of main adverse events 3 months after procedure were similar between the two groups. Conclusion In AMI patients treated with primary PCI, application of Zeek aspiration thrombectomy catheter was safe and effective, which could lower thrombosis burden, improve distal myocardium perfusion and cardiac function after procedure, did not increase the incidence of MACEs.