Chantadansuwan Thamarath, Kehasukcharoen Wirash, Hengrussamee Kriengkrai
Cardiology & Intervention Department, Central Chest Institute, Nonthaburi, Thailand.
J Med Assoc Thai. 2012 Aug;95 Suppl 8:S83-8.
Primary percutaneous coronary intervention (PCI) in acute ST elevation myocardial infarction (STEMI) is a clinical challenge. Adequate thrombus removal before stenting is an important factor that predicts procedural success, and finally reflects to clinical outcomes.
In the present report, 2 cases of acute STEMI underwent primary PCI. Coronary angiogram (CAG) in both cases showed a large amount of coronary thrombus (TIMI thrombus grade 4 & grade 5), with no response to several attempts of manual aspiration with thrombus aspiration catheter Then, Angiojet rheolytic thrombectomy, a catheter-based, device was used antegradely. Repeated CA G showed thrombus was significantly eliminated. Both patients were successfully stented with direct stent technique at culprit arteries, resulted in good angiographic results and inhospital outcomes.
Angiojet, a rheolytic thrombectomy device, is a viable option to remove thrombus in primary PCI, especially in cases with massive thrombus load and failed manual aspiration.
急性ST段抬高型心肌梗死（STEMI）的直接经皮冠状动脉介入治疗（PCI）是一项临床挑战。支架置入前充分清除血栓是预测手术成功的重要因素，并最终反映在临床结果上。
在本报告中，2例急性STEMI患者接受了直接PCI。两例患者的冠状动脉造影（CAG）均显示大量冠状动脉血栓（TIMI血栓分级为4级和5级），使用血栓抽吸导管多次手动抽吸均无反应。然后，使用基于导管的Angiojet血栓溶解切除术进行顺行操作。重复CAG显示血栓明显清除。两名患者均在罪犯血管成功采用直接支架技术置入支架，血管造影结果良好，住院结局良好。
Angiojet血栓溶解切除装置是直接PCI中清除血栓的可行选择，尤其是在血栓负荷量大且手动抽吸失败的情况下。
