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急性心肌梗死中的血栓抽吸:概念、临床试验及现行指南

Thrombus aspiration in acute myocardial infarction: concepts, clinical trials, and current guidelines.

作者信息

Vandermolen Sebastian, Marciniak Maciej, Byrne Jonathan, De Silva Kalpa

机构信息

aSt Thomas' Hospital bKing's College Hospital, London cEast Surrey Hospital, Redhill, Surrey, UK.

出版信息

Coron Artery Dis. 2016 May;27(3):233-43. doi: 10.1097/MCA.0000000000000335.

Abstract

The pathogenesis that underlies acute myocardial infarction is complex and multifactorial. One of the most important components, however, is the role of thrombus formation following atherosclerotic plaque rupture, leading to sudden coronary occlusion and subsequent ischemia and infarction. Thrombus aspiration provides the opportunity of intracoronary clot extraction with the aim to improve coronary and myocardial perfusion, by reducing the risk of no-reflow secondary to distal embolization of thrombus. The utility of thrombus aspiration during primary percutaneous coronary intervention has been assessed in an increasing number of observational and randomized studies. This article reviews the contemporary data and provides insights into the validity of thrombus aspiration in the setting of acute myocardial infarction.

摘要

急性心肌梗死的发病机制复杂且涉及多因素。然而,最重要的因素之一是动脉粥样硬化斑块破裂后血栓形成的作用,这会导致冠状动脉突然闭塞,继而引发缺血和梗死。血栓抽吸提供了冠状动脉内取出血栓的机会,目的是通过降低血栓远端栓塞继发的无复流风险来改善冠状动脉和心肌灌注。越来越多的观察性和随机研究对在直接经皮冠状动脉介入治疗期间进行血栓抽吸的效用进行了评估。本文回顾了当代数据,并深入探讨了在急性心肌梗死情况下血栓抽吸的有效性。

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