Objective: The beneficial effect of percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) has been well established, but there is the problem of no-reflow phenomenon which is an a...Objective: The beneficial effect of percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) has been well established, but there is the problem of no-reflow phenomenon which is an adverse prognostic factor in primary PCI. In the present study the effect of a distal protection device (PercuSurge GuardWire; GW) on epicardial blood flow and myocardial perfusion was evaluated. Methods and Results: Patients with AMI were randomly divided into 2 groups, the GW and the control groups. The GW group included 52 patients with AMI who underwent primary PCI with GW protection and the control group included 60 patients who underwent primary PCI without GW protection. Epicardial blood flow in the infarct-related artery (IRA) and myocardial perfusion were evaluated according to the thrombolysis in myocardial infarction (TIMI) flow grade and the myocardial blush grade (MBG). We found TIMI score of 3 was obtained significantly more frequently in the GW group (96%) than in the control group (80%). The MBG score of 3 was obtained also significantly greater in the GW group (65%) than in the control group (33%). Conclusion: Primary PCI with GW protection can significantly improve epicardial blood flow and myocardial perfusion.展开更多
The no-reflow and slow blood flow in the process of PCI treatment may reduce its effectiveness and lead to expansion of infarct in size sometimes. Also the application of thrombolytic agent inside of coronary artery,p...The no-reflow and slow blood flow in the process of PCI treatment may reduce its effectiveness and lead to expansion of infarct in size sometimes. Also the application of thrombolytic agent inside of coronary artery,platelet inhibitors GP Ⅱ/Ⅲ or direct thrombectomy can＇t improve short or long-term clinical outcomes, So we evaluated the safety and efficacy of distal protection device （GuardWire PlusTM） in the acute myocardial in farction （AMI） combined with percutaneous coronary intervention （PCI）. Method Seventy-two patients with acute myocardial infarction receiving emergency PCI were randomly assigned into the distal protection group （GW group） and non-distal protection group（NGW） group. Data analyzed between the two groups were included the clinical characteristics, angiographic results, ST segment resolution, postoperative TIMI flow grade, TIMI frame count, myocardial blush grade, the left ventricular ejection fraction （LVEF） by eehocardiography in a Week after or 3 months after PCI, myocardial enzymes,preoperative and postoperative neuroendoerine biomarkers： endothelin （ET）, plasma renin activity （PRA）, angiotensin Ⅱ （AII）, aldosterone（ALD）, norepinephrine（NE）, epinephrine （E）. Results ST segment resolution ≥ 50% was significantly higher in the GW group （68.4%） than in NGW group （41.2%, P 〈 0.05）. Early peak CK-MB and CTNI in GW group versus NGW group （8.63 ±2.42 hours vs 11.18 ±2.26 hours,10.16 ±2.96 hours vs 12.35 ±2.06 hours）, and peak reduction difference were observed （63.3 ±9.82 vs 74.28 ＋ 6.15 P = 0.000, 18.01 ＋ 7.21 vs 21.48 ±5.61 P = 0.027）. Left ventricular ejection fraction （LVEF） was higher in GW group （P = 0.01） than in NGW group. TIMI grade exhibited no difference while TIMI frame count （P = 0.043） and myocardial blush grade were significantly different （P = 0.0001）. Postoperative biomarkers in endocrine expression were higher significantly in NGR group （P 〈 0.05）. Conclusions Emergency PCI combined with distal protection device can help prevent distal embolism, reduce the risk of no-reflow and slow flow and thereafter improve the prognosis in AMI patients.展开更多
Objectives To evaluate the feasibility and safety of distal protection device (PercuSurge) during percutaneous coronary intervention (PCI) in patients with acute coronary syndrome. Methods From October 2004 to August ...Objectives To evaluate the feasibility and safety of distal protection device (PercuSurge) during percutaneous coronary intervention (PCI) in patients with acute coronary syndrome. Methods From October 2004 to August 2007, 40 patients with high risk acute coronary syndrome who received primary coronary intervention were included in this study. Patients were divided into two groups according to whether PercuSurge was attempted during PCI. The basic clinical characteristics, angiographic results, and follow-up data before discharge were compared. Coronary arteries blood flow thrombolysis in myocardial infarction (TIMI) grade, TIMI myocardial perfusion (TMP) grade and the rate of no-reflow were performed in all cases after PCI. Results There was no significant difference between the two groups in basic clinical characteristics and angiography before PCI (P>0.05). All patients underwent PCI successfully in both groups. In the PercuSurge group, PCI with PercuSurge guardwire protection was performed successfully in 18 patients. There was significant difference between the two groups in TIMI 3 flows gained in target vessels after PCI. Better percentage of TMP grade 3 of target vessels was achieved in PercuSurge group. Less no-reflow were found in PercuSurge group. There were lower peak troponin I and serum MB isoenzyme of creatine kinase levels, higher left ventricular ejection fraction and smaller left ventricular end-diastolic dimension in the PercuSurge group after PCI at the date before discharge (P<0.05). There was no major adverse cardiac events in PercuSurge group, only one patient died in the control group. Conclusions This study demonstrates that using the PercuSurge Guardwire system during PCI in high risk acute coronary syndrome patients to prevent no-reflow is feasibility and safety.展开更多
文摘Objective: The beneficial effect of percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) has been well established, but there is the problem of no-reflow phenomenon which is an adverse prognostic factor in primary PCI. In the present study the effect of a distal protection device (PercuSurge GuardWire; GW) on epicardial blood flow and myocardial perfusion was evaluated. Methods and Results: Patients with AMI were randomly divided into 2 groups, the GW and the control groups. The GW group included 52 patients with AMI who underwent primary PCI with GW protection and the control group included 60 patients who underwent primary PCI without GW protection. Epicardial blood flow in the infarct-related artery (IRA) and myocardial perfusion were evaluated according to the thrombolysis in myocardial infarction (TIMI) flow grade and the myocardial blush grade (MBG). We found TIMI score of 3 was obtained significantly more frequently in the GW group (96%) than in the control group (80%). The MBG score of 3 was obtained also significantly greater in the GW group (65%) than in the control group (33%). Conclusion: Primary PCI with GW protection can significantly improve epicardial blood flow and myocardial perfusion.
文摘The no-reflow and slow blood flow in the process of PCI treatment may reduce its effectiveness and lead to expansion of infarct in size sometimes. Also the application of thrombolytic agent inside of coronary artery,platelet inhibitors GP Ⅱ/Ⅲ or direct thrombectomy can＇t improve short or long-term clinical outcomes, So we evaluated the safety and efficacy of distal protection device （GuardWire PlusTM） in the acute myocardial in farction （AMI） combined with percutaneous coronary intervention （PCI）. Method Seventy-two patients with acute myocardial infarction receiving emergency PCI were randomly assigned into the distal protection group （GW group） and non-distal protection group（NGW） group. Data analyzed between the two groups were included the clinical characteristics, angiographic results, ST segment resolution, postoperative TIMI flow grade, TIMI frame count, myocardial blush grade, the left ventricular ejection fraction （LVEF） by eehocardiography in a Week after or 3 months after PCI, myocardial enzymes,preoperative and postoperative neuroendoerine biomarkers： endothelin （ET）, plasma renin activity （PRA）, angiotensin Ⅱ （AII）, aldosterone（ALD）, norepinephrine（NE）, epinephrine （E）. Results ST segment resolution ≥ 50% was significantly higher in the GW group （68.4%） than in NGW group （41.2%, P 〈 0.05）. Early peak CK-MB and CTNI in GW group versus NGW group （8.63 ±2.42 hours vs 11.18 ±2.26 hours,10.16 ±2.96 hours vs 12.35 ±2.06 hours）, and peak reduction difference were observed （63.3 ±9.82 vs 74.28 ＋ 6.15 P = 0.000, 18.01 ＋ 7.21 vs 21.48 ±5.61 P = 0.027）. Left ventricular ejection fraction （LVEF） was higher in GW group （P = 0.01） than in NGW group. TIMI grade exhibited no difference while TIMI frame count （P = 0.043） and myocardial blush grade were significantly different （P = 0.0001）. Postoperative biomarkers in endocrine expression were higher significantly in NGR group （P 〈 0.05）. Conclusions Emergency PCI combined with distal protection device can help prevent distal embolism, reduce the risk of no-reflow and slow flow and thereafter improve the prognosis in AMI patients.
文摘Objectives To evaluate the feasibility and safety of distal protection device (PercuSurge) during percutaneous coronary intervention (PCI) in patients with acute coronary syndrome. Methods From October 2004 to August 2007, 40 patients with high risk acute coronary syndrome who received primary coronary intervention were included in this study. Patients were divided into two groups according to whether PercuSurge was attempted during PCI. The basic clinical characteristics, angiographic results, and follow-up data before discharge were compared. Coronary arteries blood flow thrombolysis in myocardial infarction (TIMI) grade, TIMI myocardial perfusion (TMP) grade and the rate of no-reflow were performed in all cases after PCI. Results There was no significant difference between the two groups in basic clinical characteristics and angiography before PCI (P>0.05). All patients underwent PCI successfully in both groups. In the PercuSurge group, PCI with PercuSurge guardwire protection was performed successfully in 18 patients. There was significant difference between the two groups in TIMI 3 flows gained in target vessels after PCI. Better percentage of TMP grade 3 of target vessels was achieved in PercuSurge group. Less no-reflow were found in PercuSurge group. There were lower peak troponin I and serum MB isoenzyme of creatine kinase levels, higher left ventricular ejection fraction and smaller left ventricular end-diastolic dimension in the PercuSurge group after PCI at the date before discharge (P<0.05). There was no major adverse cardiac events in PercuSurge group, only one patient died in the control group. Conclusions This study demonstrates that using the PercuSurge Guardwire system during PCI in high risk acute coronary syndrome patients to prevent no-reflow is feasibility and safety.
