Rathod Krishnaraj S, Hamshere Stephen M, Choudhury Tawfiq R, Jones Daniel A, Mathur Anthony
Department of Cardiology, Barts Health NHS Trust.
Department of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University, London.
Interv Cardiol. 2014 Apr;9(2):102-107. doi: 10.15420/icr.2011.9.2.102.
Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion modality in patients with ST-elevation myocardial infarction (STEMI). While PPCI is highly effective in achieving epicardial coronary reperfusion, a significant proportion of patients fail to achieve adequate myocardial reperfusion. This is in part due to the distal microembolisation of thrombus and plaque debris during PCI. Recognition of this has led to the development of a number of devices with different mechanisms of action that aim to reduce such distal embolisation and therefore improve end myocardial perfusion. Study results of thrombectomy devices however have been largely inconsistent, especially about clinical outcome data, and several meta-analyses have been carried out as a result. This review aims to critically analyse the literature data on thrombectomy during PPCI, taking into account the most recent studies and the latest meta-analyses looking to see whether thrombectomy use is associated with improved outcomes.
直接经皮冠状动脉介入治疗（PPCI）是ST段抬高型心肌梗死（STEMI）患者首选的再灌注方式。虽然PPCI在实现心外膜冠状动脉再灌注方面非常有效，但仍有相当一部分患者未能实现充分的心肌再灌注。这部分是由于PCI过程中血栓和斑块碎片的远端微栓塞所致。认识到这一点后，人们开发了许多具有不同作用机制的装置，旨在减少这种远端栓塞，从而改善心肌灌注。然而，血栓切除术装置的研究结果在很大程度上并不一致，尤其是关于临床结局数据，因此进行了几项荟萃分析。本综述旨在批判性地分析PPCI期间血栓切除术的文献数据，同时考虑到最新的研究和最新的荟萃分析，以探讨使用血栓切除术是否与改善结局相关。
