Document Detail


Percutaneous coronary arterial thrombectomy for acute myocardial infarction reduces no-reflow phenomenon and protects against left ventricular remodeling related to the proximal left anterior descending and right coronary artery.
MedLine Citation:
PMID:  17592194     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The no-reflow phenomenon during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) causes impaired myocardial reperfusion. The aim of the present study was to evaluate the impact of thrombectomy on the prevention for no-reflow phenomenon and for LV remodeling. We performed a retrospective study comparing 116 patients treated for AMI with conventional angioplasty and 89 patients treated for AMI with the combination of angioplasty and thrombectomy. We performed manual aspirating thrombectomy using Thrombuster II. Baseline clinical and lesion characteristics were similar in the 2 groups. No-reflow phenomenon was significantly reduced in the thrombectomy group compared to the controls (8% versus 18%, P < 0.05). Maximum group mean CK was not significantly different between the two groups. During 6 months of follow-up, the mean LV ejection fractions of the 2 groups were not significantly different. However, in the cases involving the proximal left anterior descending (LAD) and right coronary arteries, changes in LV end-diastolic volume index (LVEDVI), LV end-systolic volume index, maximum CK and the incidence of LV remodeling, defined as an increase in LVEDVI of > 20%, were significantly lower in the thrombectomy group than in the control group. Multiple logistic regression analysis indicated that thrombectomy with Thrombuster II significantly reduced the no-reflow phenomenon and LV remodeling. These results suggest that adjunctive pretreatment with a manual aspirating thrombectomy by Thrombuster II reduces the no-reflow phenomenon, and in cases involving the LAD and right coronary arteries, protects against LV remodeling in AMI.
Authors:
Takuya Kishi; Akira Yamada; Shuuichi Okamatsu; Kenji Sunagawa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International heart journal     Volume:  48     ISSN:  1349-2365     ISO Abbreviation:  -     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-06-26     Completed Date:  2007-11-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101244240     Medline TA:  Int Heart J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  287-302     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Aso-Iizuka Hospital, Fukuoka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Flow Velocity
Coronary Angiography
Coronary Vessels / physiopathology,  surgery*
Electrocardiography
Female
Follow-Up Studies
Gated Blood-Pool Imaging
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis,  physiopathology,  surgery*
Myocardial Reperfusion Injury / diagnosis,  physiopathology,  prevention & control*
Retrospective Studies
Stroke Volume / physiology
Thrombectomy / methods*
Treatment Outcome
Ventricular Function, Left / physiology
Ventricular Remodeling / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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