| Summary: | 碩士 === 中山醫學大學 === 醫學研究所 === 100 === Objective: Patients with acute ST-elevation myocardial infarction may have persistent impairment of microvascular blood flow even after successful primary percutaneous coronary intervention ( PCI ). Distal embolization is a possible mechanism of microvascular dysfunction and impaired myocardial perfusion. There has been increasing interest in adjunctive mechanical thrombectomy to improve outcomes in primary PCI. The aim of the present report is to study the role of AngioJet thrombectomy in primary PCI for acute ST-elevation myocardial infarction .
Method and Materials: This is a retrospective cohort study. Patients presented with acute ST-elevation myocardial infarction and received primary PCI in ChangHua Christian Hospital between Jan. 2003 and Oct. 2007 were enrolled. Totally 313 patients were included, 219 patients are in the AngioJet group and the other 94 patients are in the control group. The baseline characteristics, angiographic findings and 6-months survival in these two groups were recorded.
Results: Patients in the AngioJet group have more male, cardiac enzymes elevation and angiographically visible thrombus. The angiographic findings showed that 94.1% in the AngioJet group have TIMI 3 flow after primary PCI, but only 80.9% in the control group have the same TIMI 3 flow. Besides, we also find the similar MBG flow between two groups. MBG 3 flow was achieved in 56.2% of the AngioJet group and 39% of the control group. The 6-months survival did not show significant difference between groups ( 93.2% versus 91.5% ).
Conclusion and Suggestion: AngioJet thrombectomy in primary PCI for patients with acute ST-elevation MI can improve TIMI flow and MBG flow. But it remains to be established weather the device improves outcomes. The current evidence does not support the routine use of the AngioJet system in primary PCI. But in selected patients with large burden of thrombus, it still can provide clinical benefit as an adjunct to primary PCI.
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