الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Thrombus aspiration for STEMI may improve myocardial perfusion. However, these favorable results called into a question by data indicating not only lack of efficacy, but a risk of potentially deleterious complications. Aim: Aim was to assess the effect of thrombus aspiration during primary percutaneous coronary intervention (PPCI) on procedural angiographic results {TIMI flow, myocardial blush grade (MBG), Thrombus score} and major adverse cardiac and cerebrovascular events (MACCE). Methodology: All consecutive STEMI patients candidate for PPCI and admitted to Critical Care Department, Cairo University hospitals, from beginning of January 2010 until the end of December 2015, managed either by thrombectomy before primary PCI or conventional PCI upon operator discretion, were enrolled in the study.607 subjects 2 440 subjects (72.5%) retrospectively and 167 subjects (27.5%) prospectively3 within 12 hours of symptoms divided into group with thrombectomy before PPCI (N 107) 18%, group with Conventional PCI (N 500) 82%. ST segment resolution, peak CK-MB, TIMI score, and MBG were assessed, SYNTAX score pre and post procedure were calculated, stent number, diameter, and length were reported and follow up MACCE in hospital for2 all the study group 607 subjects 2 and 1 year for3 prospective group 167 subjects 2 were done. Results: Mean values for peak CKMB were less in thrombectomy group (228±174 I/U vs 269±186 I/U p 0.04), ST segment resolution >70% occurred more in thrombectomy group {63 patients(58.9%) vs 233 patients (46.6%) p 0.001} in thrombectomy vs conventional group respectively. Mean values for TIMI score pre procedure were (0±0.2 vs 0.4±0.8 p 0.001), while TIMI post procedure were (2.9±0.1vs 2.8±0.2 p 0.06), MBG mean values were (2.4±0.6 vs 2.0±1 p 0.001), thrombus score was higher in thrombectomy group (4.6±0.4 vs 0.8±1.7 p 0.001) in thrombectomy vs conventional group respectively. Mean values for SYNTAX score pre procedure were(16±6 vs 17±7 p 0.2) while mean values for Syntax score post procedure were (14±6 vs15±7 p0.3) in thrombectomy vs conventional group respectively |