用X-sizer导管系统进行冠状动脉内血栓切除可以改善心表流动,并加速急性冠状动脉综合征患者的ST段分辨率:一项前性,随机化,受控研究
Gilbert Beran1, Irene Lang, Wolfgang Schreiber
1Department of Cardiology and Emergency Medicine University of Vienna, Vienna, Austria.
Circulation
|May 22, 2002
概括
与常规穿皮冠状动脉干预 (PCI) 相比,先治疗急性冠状动脉综合征 (ACS) 患者的X-sizer血栓切除系统改善了上心流量和加速了ST段分辨率. 这一策略显示了与血栓相关的ACS管理的前景.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管医学 血管医学
背景情况:
- 针对急性冠状动脉综合征 (ACS) 的皮肤冠状动脉干预 (PCI) 可能导致血栓脱离,流量减少和微循环受损.
- 一项前性研究比较了传统的PCI与涉及X-sizer血栓切除术预治疗的策略.
研究的目的:
- 评估X-sizer血栓切除术预治疗在患有ACS和疑似冠状动脉内血栓的患者中的疗效.
- 为了比较X-sizer预处理和传统PCI之间的表心流量和微循环功能.
主要方法:
- 66名ACS患者 (49名ST升高心肌梗塞 (STEMI) 患者) 被随机分组1:1进行X-sizer预治疗加PCI或单独使用常规PCI.
- 干预后评估了心上流量,微血管功能和ST段变化.
主要成果:
- 在STEMI患者中,X-sizer预治疗导致更低的校正TIMI框架数 (18.3vs24.7;P<0.05) 和显著减少ST段升高后干预.
- 在83%的X-sizer治疗患者中,ST细分的分辨率超过50%,而对照组的52% (P<0.03).
- X-sizer治疗是ST段分辨率>50% (OR4.35;P<0.04) 的独立预测因素.
结论:
- 在疑似血栓的ACS患者中,使用X-sizer导管系统进行预治疗,可以改善心上膜流.
- 与传统的PCI相比,X-sizer系统加速了ST段的分辨率,这表明了微血管再输的改善.
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