الفهرس 
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Abstract
he idea of an occluding thrombus as an etiology for ST elevation myocardial infarction (STEMI) and its dissolution as a treatment, had been around since 1950s (1).
The aim of this study is to prove that thrombus-aspirating device (DIVER CE catheter), during PPCI improves acute myocardial reperfusion compared with standard PCI in patients with STEMI, measured by ST-segment resolution (STR) and myocardial blush grade (MBG), compared with standard PPCI.
This study was conducted in the National Heart Institute during three years; between January 2009 to December 2011. The study enrolled 70 patients with acute ST elevation Ml. The patients were divided into two groups: Group (A) included thirty five patients who underwent primary percutaneous coronary intervention (PPCI) with thrombus aspiration (TA). Group (B) included thirty five patients who underwent PPCI without TA i.e standard PCI (SP).
The patients in our study were predominantly male (77.4 %) with a mean age over fifty two years in both groups.
All patients were accessed using the femoral approach with a 6 french (F) system. Aspiration Catheter used was Diver CE 6F system. Aspiration was done before stenting or balloon predilatation.
All patients were pre-treated with aspirin 300 mg orally or intravenously, clopidogrel 300 mg orally, and unfractionated heparin 10 000 IE intravenously.
During the intervention, all patients received glycoprotein IIb/IIIa inhibitor and dose was reduced for those with DM, renal impairment and those who received thrombolysis.
Our primary end-points were the post procedural STR and MBG: STR > 70% denoting proper reperfusion was in 25 cases (42.9%) in group A (TA), in comparison to 3 cases (8.6%) in group B. (p-value <0.005). 32 patients in group A (TA) (91.4%) versus 18 patients in group B (54.3%) had MBG flow equal or more than 2 denoting proper reperfusion (p-value < 0.005).
Our secondary end-point was in-hospital MACE. We reported death of three patients in the non aspiration group, however this did not reach statistical significance (p-value = 0.120)
A very important observation was the significant reduction in no-reflow incidence in the TA group; no-reflow was 2.9% in group A versus 28.6% in group B (p-value < 0.003).
from our study, we recommend thrombus aspiration in all cases of STEMI to improve the reperfusion and to prevent the no reflow.
SUMMARY
T
he idea of an occluding thrombus as an etiology for ST elevation myocardial infarction (STEMI) and its dissolution as a treatment, had been around since 1950s (1).
The aim of this study is to prove that thrombus-aspirating device (DIVER CE catheter), during PPCI improves acute myocardial reperfusion compared with standard PCI in patients with STEMI, measured by ST-segment resolution (STR) and myocardial blush grade (MBG), compared with standard PPCI.
This study was conducted in the National Heart Institute during three years; between January 2009 to December 2011. The study enrolled 70 patients with acute ST elevation Ml. The patients were divided into two groups: Group (A) included thirty five patients who underwent primary percutaneous coronary intervention (PPCI) with thrombus aspiration (TA). Group (B) included thirty five patients who underwent PPCI without TA i.e standard PCI (SP).
The patients in our study were predominantly male (77.4 %) with a mean age over fifty two years in both groups.
All patients were accessed using the femoral approach with a 6 french (F) system. Aspiration Catheter used was Diver CE 6F system. Aspiration was done before stenting or balloon predilatation.
All patients were pre-treated with aspirin 300 mg orally or intravenously, clopidogrel 300 mg orally, and unfractionated heparin 10 000 IE intravenously.
During the intervention, all patients received glycoprotein IIb/IIIa inhibitor and dose was reduced for those with DM, renal impairment and those who received thrombolysis.
Our primary end-points were the post procedural STR and MBG: STR > 70% denoting proper reperfusion was in 25 cases (42.9%) in group A (TA), in comparison to 3 cases (8.6%) in group B. (p-value <0.005). 32 patients in group A (TA) (91.4%) versus 18 patients in group B (54.3%) had MBG flow equal or more than 2 denoting proper reperfusion (p-value < 0.005).
Our secondary end-point was in-hospital MACE. We reported death of three patients in the non aspiration group, however this did not reach statistical significance (p-value = 0.120)
A very important observation was the significant reduction in no-reflow incidence in the TA group; no-reflow was 2.9% in group A versus 28.6% in group B (p-value < 0.003).
from our study, we recommend thrombus aspiration in all cases of STEMI to improve the reperfusion and to prevent the no reflow.