急性心肌梗死直接经皮冠状动脉介入治疗期间的血栓抽吸：临床证据与指南综述
Thrombus aspiration during primary percutaneous coronary intervention for acute myocardial infarction: A review of clinical evidence and guidelines.
作者信息
Mahmood Muhammad Muzaffar, Watt Jonathan, Ahmed Javed M
机构信息
Muhammad Muzaffar Mahmood, Jonathan Watt, Javed M Ahmed, Cardiology Department, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, United Kingdom.
出版信息
World J Cardiol. 2015 Dec 26;7(12):889-94. doi: 10.4330/wjc.v7.i12.889.
Abstract
Acute ST segment elevation myocardial infarction (STEMI) is characterized by complete thrombotic occlusion of a major coronary artery. Early recanalization of the infarct-related artery is most efficiently delivered by primary percutaneous coronary intervention (PPCI), however this does not always restore normal myocardial perfusion, mainly due to distal embolization of the thrombus and microvascular obstruction. Early evidence for manual thrombus aspiration during PPCI was promising and this was once considered an important aspect of the procedure, especially in patients with a high thrombus burden. However, a large body of evidence from recent major randomized controlled trials (notably TASTE and TOTAL) does not support the routine use of manual thrombus aspiration in patients with STEMI undergoing PPCI.
摘要
急性ST段抬高型心肌梗死（STEMI）的特征是主要冠状动脉完全血栓性闭塞。梗死相关动脉的早期再通最有效地通过直接经皮冠状动脉介入治疗（PPCI）实现，然而，这并不总能恢复正常的心肌灌注，主要原因是血栓的远端栓塞和微血管阻塞。PPCI期间手动血栓抽吸的早期证据很有前景，这曾被认为是该手术的一个重要方面，尤其是在血栓负荷高的患者中。然而，最近大型随机对照试验（尤其是TASTE和TOTAL）的大量证据不支持在接受PPCI的STEMI患者中常规使用手动血栓抽吸。
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