Open AccessIn-hospital results of rheolytic catheter thrombectomy in patients with STEMI
Author(s) -
Малхасьян Максим Викторович,
В. А. Кузнецов,
И. С. Бессонов,
П И Павлов
Publication year - 2016
Publication title -
patologiâ krovoobraŝeniâ i kardiohirurgiâ/patologiâ krovoobrašeniâ i kardiohirurgiâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.136
H-Index - 3
eISSN - 2500-3119
pISSN - 1681-3472
DOI - 10.21688/1681-3472-2016-3-54-61
Subject(s) - cardiogenic shock , medicine , conventional pci , myocardial infarction , cardiology , thrombus , right coronary artery , catheter , angioplasty , occlusion , artery , surgery , coronary angiography
Aim. The article focuses on the evaluation of short-term efficacy of rheolytic thrombectomy (AngioJet) in patients with STEMI. Methods. 188 patients (85.6% men) with STEMI underwent primary PCI by means of rheolytic catheter thrombectomy (AngioJet). The mean age was 54.1 ± 10.7 years. 32 (17 %) of patients had old myocardial infarction. 104 (55.9 %) patients were diagnosed with ST-elevated inferior myocardial infarction. 22 (12 %) patients were operated under cardiogenic shock. Mean time from the appearance of symptoms to admission was 222.5 [70, 584] min. Anterior interventricular artery (38.3 %) and right coronary artery (43.6 %) were the main infarction-related arteries. Results. Complete thrombotic occlusion of the coronary artery occurred in 144 (77.4%) patients. Mean “door-to-balloon” time amounted to 41.5 [30; 60]. Coronary thrombus was fully removed in 107 (60.8%) of patients. Stents with antiproliferative effect were implanted in 48.8 % of patients. Immediate angiographic success was achieved in 177 (94.1%) cases. Mean time of PCI was 60 [50; 80] min. PCI complications were registered in 3 (1.6%) patients. Intraoperative life-threatening arrhythmias happened in 22 (11.7 %) patients. The phenomenon of "no-reflow" occurred in 6 (3.2%) PCI cases. The rate of in-hospital mortality was 5.9%, including patients with cardiogenic shock (36.4%) and those without it (1.9 %). MACCE (main adverse cardio-cerebral events) were observed in 15 (8%) cases. According to ECG data obtained postoperatively, 26 % of patients demonstrated no regional asynergy, while a decrease in myocardial contractile function occurred in just 26 % of cases, with the average left ventricular ejection fraction running to 57.5±9 %. Mean in-hospital stay was 9.5±0.6 days. Conclusion. The results of this study suggest that rheolytic catheter thrombectomy (AngioJet) is a safe and effective modality. Immediate hospital results show low rate complications and low in-hospital mortality. Received 13 April 2016. Accepted 9 June 2016. Conflict of interest: The authors declare no conflict interests.