Clinical Study Of Precise Thrombus Aspiration In Emergency PCI Of STEMI Patients

Objective:To verify the benefit of thrombus aspiration in STEMI patients with high thrombus load;The types of lesions suitable for thrombus aspiration were analyzed.Methods:From January 1,2019 to December 31,2021,400 patients with high thrombus load STEMI who underwent emergency PCI in Bethune Hospital,Shanxi Province,were selected.They were separated into simple PCI group and thrombus aspiration group on the basis of whether to perform thrombus aspiration,with 200 patients in each group.The simple PCI group was treated with PCI alone;The thrombus aspiration group was treated with PCI combined with thrombus aspiration.That aims to compare the improvement of cardiac function and the incidence of adverse cardiovascular events between the two groups.Results:There was a statistically significant difference in TIMI blood flow grading between the two groups after thrombus aspiration and immediately after PCI(P<0.05).It was the same with the incidence of non reflow-slow blood flow between the two groups after surgery(P<0.05).The percentage of ST segment regression ≥ 50% in the thrombus aspiration group was higher than that in the simple PCI group,and the difference was statistically significant(P<0.05);The numerical amount of corrected TIMI frames measured in the thrombus aspiration group was lower,and the difference has statistical significance(P<0.05);In many ways,such as the ejection fraction,left ventricular end-systolic diameter and left ventricular end-diastolic diameter,there was no obvious distinction between the thrombus aspiration group and the simple PCI group before treatment(P>0.05);After treatment,the ejection fraction of the thrombus aspiration group was higher,and the left ventricular end systolic diameter and left ventricular end diastolic diameter were smaller,the difference was significant(P<0.05).The incidence of MACE events and stroke in the thrombus aspiration group was smaller than that in the simple PCI group,and there was a significant difference between them(P<0.05).Conclusion:For patients with definite diagnosis of STEMI and heavy load of coronary artery thrombus,PPCI combined with thrombus aspiration can reduce the incidence of slow flow and no flow,increase myocardial reperfusion,and reduce the incidence of major adverse cardiovascular events in the long term,with better clinical effect.Thrombus aspiration is more suitable for STEMI patients with high thrombus load.