摘要
目的 评价远端血栓保护装置PercuSurgeGuardwire在急性心肌梗死 (AMI)的高危急诊经皮冠状动脉介入 (PCI)治疗中预防远端血栓栓塞并发症的临床疗效及安全性。方法 92例AMI患者为研究对象 ,其中 4 7例在急诊PCI过程中联合应用PercuSurgeGuardwire装置(PercuSurge组 ) ,平均年龄 (6 1 4± 7 1)岁 ;另 4 5例进行常规无PercuSurgeGuardwire保护的急诊PCI (对照组 ) ,平均年龄 (6 4 9± 8 3)岁。比较两组急诊PCI术后即刻冠状动脉TIMI血流及院内、 30天主要心脏不良事件发生率。结果 全部病例均成功植入血管支架并放置PercuSurgeGuardwire保护装置。平均阻滞球囊直径 (4 5± 0 5 )mm ,平均阻滞时间 (8 7± 5 9)min。PercuSurge组术后TIMI 3级血流率显著高于对照组 (95 74与 86 6 7% ,P <0 0 5 ) ,无血流事件发生率显著降低 (0 %与 6 6 7% ,P <0 0 5 )。并发症包括 :血管夹层 1例 (2 13% ) ,远端小血管血栓栓塞 1例 (2 13% )。随访全部患者 ,PercuSurge组院内及 30天心脏不良事件发生率均显著低于对照组 (分别为 2 13%与13 33% ,2 13%与 8 89% ,P值均小于 0 0 5 )。结论 联合应用PercuSurgeGuarwire远端保护装置在AMI患者的急诊PCI过程中可安全有效地预防远端血栓栓塞并发症的发生 。
Objective Distal embolization during percutaneous coronary intervention (PCI) is associated with the significant increase in major adverse cardiac events (MACE). We evaluate the safety and efficacy of the combination of PCI and the PercuSurge Guardwire in the treatment of acute myocardial infarction(AMI) patients. Methods Ninety-two AMI patients underwent emergent PCI either with the PercuSurge Guardwire (PercuSurge group) or without (control group).PercuSurge group had 47 patients with mean age (61.4±7.1) years, and control group 45 patients with mean age (64.9±8.3) years. Immediate blood flow after PCI and MACE at 30 day after PCI were compared. Results Stents and Guardwire were successfully applied in all patients. The mean diameter of occlusive balloon was (4.5±0.5) mm and the mean occlusive time was (8.7±5.9) min. Immediate blood flow was improved significantly in PercuSurge group compared to the control group.After the use of PercuSurge Guardwire,the complications included distal thromboembolism (2.13%) and coronary dissection (2.13%). The MACE during in-hospital and at 30-day follow-up of Precusurge group were significantly less than control group ( 2.13% vs 13.33 % and 2.13 % vs 8.89%, respectively, P<0.05). Conclusions This study demonstrates the feasibility and safety of using the PercuSurge Guardwire system during PCI in AMI patients to prevent distal embolization.Immediate blood flow is significantly improved,and no-blood-flow rate is markedly reduced. MACE during in-hospital and at 30-day follow-up markedly decrease.
出处
《中华急诊医学杂志》
CAS
CSCD
2004年第9期581-583,共3页
Chinese Journal of Emergency Medicine
