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目的:评价Percusurge远端保护装置(DPD)在急性ST段抬高心肌梗死(STEMI)患者冠状动脉介入治疗中的有效性及安全性。方法:104例接受急诊PCI治疗的STEMI患者分2组,DPD组48例,对照组56例。比较2组间的基础临床状况、造影情况、介入治疗结果。病变血管术后均行TIMI分级、TIMI计帧。结果:DPD组48例全部抽出肉眼可见的红色、白色碎屑或红色血栓条。2组间的基础临床状况、术前造影情况均差异无统计学意义。但DPD组与对照组间术后TIMI2～3级为91..7%和76.8%(P<0.05),发生无复流现象为4.2%和16.1%(P<0.05);远端小血管栓塞为8.3%和23.2%(P<0.05);2组的TIMI帧数为20.2±2.8和31.2±4.4(P<0.05);住院期间均无主要心血管事件发生。结论:PercusurgeDPD能有效保护远端血管,吸出冠状动脉内血栓,避免远端血管栓塞。该方法无严重并发症发生,在急性心肌梗死等冠状动脉内存在大量血栓的情况下行介入治疗时具有良好的治疗效果。
Objective: To evaluate the efficacy and safety of Percusurge distal protection device (DPD) in coronary interventional therapy in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: A total of 104 STEMI patients undergoing emergency PCI were divided into two groups: 48 in DPD group and 56 in control group. The basic clinical conditions, contrast, and interventional outcome were compared between the two groups. TIMI grading was performed after the lesioned vessel and TIMI frame was calculated. RESULTS: All 48 patients in the DPD group had red, white debris or red thrombus visible to the naked eye. There was no significant difference in the basic clinical conditions and preoperative contrast between the two groups. However, postoperative TIMI grade 2 to grade 3 in DPD group were 91.7% and 76.8% respectively (P <0.05), and no-reflow occurred in 4.2% and 16.1% (P <0.05), while distal small vessel embolism (P <0.05). The TIMI frames in the two groups were 20.2 ± 2.8 and 31.2 ± 4.4 (P <0.05) respectively. No major cardiovascular events occurred during hospitalization. Conclusion: Percusurge DPD can effectively protect the distal blood vessels, aspiration of the coronary artery thrombosis, to avoid distal embolization. The method has no serious complication, and has good curative effect in interventional therapy when there is a large amount of thrombus in the coronary artery such as acute myocardial infarction.