血栓抽吸在急性ST段抬高型心肌梗死患者直接经皮冠状动脉介入治疗中的应用

Thrombus aspiration in primary percutaneous coronary intervention for patients with acute ST-segment elevation myocardial infarction

急性ST段抬高型心肌梗死患者采用直接经皮冠状动脉介入治疗可以实现及时的心肌机械再灌注。但对于心外膜血管闭塞的患者来说,进行球囊血管成形术和支架置入术可能会导致管腔内的血栓破裂,从而引起心肌再灌注不良和微循环障碍,而血栓抽吸的应用则可以有效地预防远端血管栓塞等不良事件的发生。本综述主要着眼于血栓抽吸在急性ST段抬高型心肌梗死患者临床介入治疗方面的应用,并对其优缺点和相关研究的结果进行讨论。

Primary percutaneous coronary intervention,through which mechanical reperfusion can be realized in patients with acute ST-segment elevation myocardial infarction,is superior to fibrinolysis in terms of short-term and long-term outcome.But for patients who have an occluded epicardial vessel,balloon angioplasty and stent implantation can cause disruption of the frail thrombus containing lesions,that associated with suboptimal myocardial reperfusion and microcirculatory obstruction.However,the use of thrombus aspiration during primary angioplasty can effectively prevent many adverse events like distal embolization of atherothrombotic material.Here we review the applications of thrombus aspiration in primary percutaneous coronary intervention for patients with acute STsegment elevation myocardial infarction,and discuss their merits and demerits and the reported results.