Application of a thrombus-aspirating device ZEEK catheter to primary percutaneons coronary intervention for acute myocardial infarction / 中华急诊医学杂志

ABSTRACT

Objective To evaluate the clinical effectiveness of a new and easy-to-use thrombus-aspirating device for primary percutaneous trans-radial coronary intervention (PCI). Method From March 2006 to June 2008, fifty acute myocardial infarction (AMI) patients with angiographic evidence of high-burden coronary throm-bus treated with thrombus aspiration were enrolled in a single center retrospective study. Thrombotic clot was aspi-rated before stent was implanted in the infarct-related coronary artery. Thrombolysis in myocardial infarction(TIMI) flow, corrected TIMI frame count (cTFC), TIMI myocardial perfusion grade(TMPG), and rate of no-reflow were observed with coronary augiography. Acute thrombosis and subacute thrombosis in stent during hospital stay were investigated. Myocardial ischemic events, revascularization and mortality during the following period were also in-vestigated. Paired t -test was used for statistical analysis. Results Thrombus was completely removed in 35 pa-tients (70%) and partially removed in 15 patients (30%) seen immediately after thrombus aspiration. There were significant improvements both in postoperative TIMI flow (0 vs. 2.7±0.5, P <0.01) and TMPG (0 vs. 2.6±0.8, P <0.01), while cTFC was 20.2±16.8 after the thrombus aspiration. No severe complication occurred during and after operation. Conclusions Trans-radial thrombas-aspiration in primary PCI is clinically safe and feasible. The use of aspiration catheter (ZEEK) is a simple and effective approach to the treatment of coronary artery stenosis associated with thrombus because it elevates the successful rate of treatment,reduces the incidence of no-reflow,and results in better prolonged-term outcome.