RESUMO
Objective To study the efficacy of the percutaneous thrombectomy for the no-reflow of acute myocardial infarction(AMI)in elderly patients with angiographically proven thrombus.Methods A total of 46 patients(≥60 years old)with AMI and coronary thrombus shown by angiography were randomly divided into group of PCI therapy(23 cases)and group of PCI plus percutaneous thrombectomy(23 cases).At 24 hours and 1 week after PCI,real-time imaging was performed by contrast pulse sequencing technology.Contrast score index(CSI),endocardial length of contrast defect(CDL),regional wall motion score index(WMSI)and wall motion abnormality(WML)were calculated. Results At each time point,in patients treated with a pereutaneous thrombectomy,CSI,CDL/LV length(%),WMSI and WML/LV length(%)were significantly lower than in PCI group[(2.0±0.3)vs.(2.5±0.7),(1.5±0.4)vs.(2.0±0.5),(15.5±5.4)%vs.(22.8±4.9)%,(9.6±2.5)%vs.(21.5±4.6)%,(2.1±0.5)vs.(2.4±0.7),(1.5±0.5)us.(2.1±0.5),(24.5±5.3)%vs.(35.6±8.3)%,(15.9±5.0)vs.(27.6±6.4)%,P<0.05 or P<0.01]. Conclusions The beneficial effect of the thrombectomy occurs at the microvascular level.Thrombectomy reduces the no-flow and the extent of microvascular obstruction,thus it was a feasible therapy in elderly patiens with AMI.