Singh Mandeep, Tiede Daniel J, Mathew Verghese, Garratt Kirk N, Lennon Ryan J, Holmes David R, Rihal Charanjit S
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Catheter Cardiovasc Interv. 2002 May;56(1):1-7. doi: 10.1002/ccd.10176.
The AngioJet thrombectomy device removes thrombus by creating a negative pressure and causing fragmentation of the thrombus. The objective was to study the safety and efficacy of this thrombectomy device during coronary interventions and to report the results of our experience. We studied 72 patients (mean age, 64.9 +/- 12.6 years; 79% males) who had an AngioJet procedure during coronary intervention; 33 (46%) had vein graft intervention. All patients had angiographic thrombus. Most patients presented either with unstable angina (54%) or acute myocardial infarction (32%) within 24 hr. The procedural success was high with AngioJet (93%). TIMI grade 3 flow was achieved in 79% of lesions treated with AngioJet. In-hospital mortality was 1.4%, death/Q-wave myocardial infarction was 4.2%, and the composite endpoint of death and Q-wave myocardial infarction/revascularization was 5.6% for patients undergoing AngioJet. Subgroup analysis of patients with vein graft intervention demonstrated high procedural success in those undergoing AngioJet (91%). At 1-year follow-up of the successful percutaneous interventions with AngioJet, the mortality, death/Q-myocardial infarction, and composite endpoint rates were 10%, 13.3%, and 35.5%, respectively. Long-term event-free survival was worse in vein graft interventions. The incidence of death, death/myocardial infarction, or composite endpoints at 1 year was 16%, 19%, and 46%, respectively. High procedural success can be achieved with the AngioJet thrombectomy device in lesions containing thrombus. It is effective in both native coronary arteries and vein graft interventions. However, the long-term outcome of patients with vein graft intervention was worse.
AngioJet血栓切除术装置通过产生负压并导致血栓破碎来清除血栓。目的是研究这种血栓切除术装置在冠状动脉介入治疗期间的安全性和有效性，并报告我们的经验结果。我们研究了72例患者（平均年龄64.9±12.6岁；79%为男性），他们在冠状动脉介入治疗期间接受了AngioJet手术；33例（46%）进行了静脉桥血管介入治疗。所有患者均有血管造影显示的血栓。大多数患者在24小时内表现为不稳定型心绞痛（54%）或急性心肌梗死（32%）。AngioJet手术的成功率很高（93%）。接受AngioJet治疗的病变中，79%实现了TIMI 3级血流。接受AngioJet治疗的患者住院死亡率为1.4%，死亡/Q波心肌梗死发生率为4.2%，死亡和Q波心肌梗死/血运重建的复合终点发生率为5.6%。对接受静脉桥血管介入治疗的患者进行亚组分析显示，接受AngioJet治疗的患者手术成功率很高（91%）。在对成功接受AngioJet经皮介入治疗的患者进行1年随访时，死亡率、死亡/Q波心肌梗死发生率和复合终点发生率分别为10%、13.3%和35.5%。静脉桥血管介入治疗的长期无事件生存率较差。1年时死亡、死亡/心肌梗死或复合终点的发生率分别为16%、19%和46%。AngioJet血栓切除术装置在含血栓病变中可实现较高的手术成功率。它在自身冠状动脉和静脉桥血管介入治疗中均有效。然而，静脉桥血管介入治疗患者的长期预后较差。
