Belli G, Pezzano A, De Biase A M, Bonacina E, Silva P, Salvadè P, Piccalò G, Klugmann S
Section of Interventional Cardiology, Department of Cardiology "A. De Gasperis," Niguarda Hospital, Milan, Italy.
Catheter Cardiovasc Interv. 2000 Jul;50(3):362-70. doi: 10.1002/1522-726x(200007)50:3<362::aid-ccd22>3.0.co;2-h.
Primary percutaneous intervention for acute occlusion of a native coronary artery may be complicated by distal embolization of plaque or thrombotic debris, with infarct extension. We tested the clinical application of a new therapeutic strategy combining maximal antiplatelet therapy, with glycoprotein IIb/IIIa inhibition, and adjunctive mechanical protection from distal embolization and direct aspiration of thrombus with a new balloon and catheter system (PercuSurgetrade mark). Successful aspiration of thrombus could be obtained in 7 out of 8 attempted procedures, with inability to negotiate the angulated take-off of the circumflex coronary artery in one patient. The current mechanical characteristics of the device, primarily developed for use in larger saphenous vein grafts, and certain caveats and limitations are discussed. New dedicated systems should be available in the near future for the native coronary circulation. Excellent immediate angiographic results were obtained in all treated patients, without evidence of loss of distal branches and no intraprocedural complications.
对自身冠状动脉急性闭塞进行的初次经皮介入治疗可能会因斑块或血栓碎片的远端栓塞而并发梗死扩展。我们测试了一种新治疗策略的临床应用，该策略结合了最大程度的抗血小板治疗、糖蛋白IIb/IIIa抑制以及通过一种新型球囊和导管系统（PercuSurge商标）对远端栓塞进行辅助机械保护和直接抽吸血栓。在8例尝试的手术中，有7例成功抽吸到血栓，1例患者因无法通过迂曲的冠状动脉回旋支起始部。讨论了该主要为用于较大的大隐静脉移植物而研发的装置当前的机械特性，以及某些注意事项和局限性。在不久的将来应该会有适用于自身冠状动脉循环的新型专用系统。所有接受治疗的患者均获得了极佳的即时血管造影结果，没有远端分支丢失的迹象，也没有术中并发症。
