Study On The Application Of Thrombus Aspiration Catheter In The Emergency PCI For STEMI Patients With High Thrombus Load

Objective: To investigate the safety and efficacy of thrombus aspiration catheter in the treatment of acute ST segment Elevation myocardial infarction(STEMI)with high thrombus load to improve myocardial reperfusion and reduce the risk of major adverse cardiovascular events(MACE).Methods: Continue to select the patients who were diagnosed as acute st-segment elevation myocardial infarction and the STEMI patients who were used Coronary angiography to diagnose with high thrombus load after admission to hospital of the department of cardiology in the sixth affiliated medical college of Guangxi medical university from July 1st,2016 to June thirtieth,2017.According to the random number form and the admission order,it was divided into the thrombus suction group(group A)and the balloon dilatation group(group B).Prior to PCI,all patients were given the load capacity aspirin(300 mg),followed by 100 mg daily maintenance;the load capacityclopidogrel(300 mg)maintain 75 mg one time a day after that.In addition,all patients were given regular medication according to the STEMI diagnosis and treatment guidelines.To record the blood flow of patients with thrombolytic test of criminal coronary artery myocardial infarction(TIMI)before and after emergency PCI in this two groups.To measure the left ventricular end-diastolic diameter(LVEDD)and the left ventricular ejection fraction(LVEF),to collect the data of 30 days on major adverse cardiovascular events(MACE)during the hospital stay and follow-up visit after the emergency PCI.Results: 1.This study had screened out 207 patients who met the inclusion criteria of STEMI in all,according to patient's order of entering into the hospital and the random number table were divided into 102 cases of group A,105 cases of group B.During the follow-up period,missing visit 1 case in group A,2cases in group B.Ultimately select out 101 cases of group A,102 cases of group B.Clinical data of two groups of patients include age,gender,hypertensive disease,diabetes,smoke,there was no statistically significance to compare suffering from criminal coronary artery with the number of lesion vascular(P>0.05average).2.Before the emergency PCI,the TIMI flow grades of the two groups both reached the diagnostic criteria of no-reflow;After the emergency PCI,the TIMI flow grades of the two groups have been improved,Among them,there were 96 cases of TIMI flow grade 3 in group A,5 cases in grade2 or under grade 2,the patients of TIMI flow grade 3 in group B have 89 cases,14 cases in grade 2 or under grade 2.To compare the difference between the two groups was statistically significant(P<0.05).3.To compare the difference between the LVEDD and the LVEF of this two groups after 7days of emergency PCI has no significance of statistics(P>0.05).4.The rate of the major adverse cardiovascular events between this two groups while in hospital or postoperative after 30 days follow-up are different,but there isn't any statistical significance to compare the total rate of happening the major adverse cardiovascular events between this two groups(P =0.335).Conclusion: The thrombosis suction catheter can improve the culprit vessel of TIMI flow grade of the patients who suffers from STEMI with high thrombus load after emergency PCI.To lower the rate of the slow blood flow or even NO-reflow to the distal end of the culprit vessel effectively.But there is no obvious effects of the death rate during hospitalization and the rate of happening the major adverse cardiovascular events after postoperative 30 days follow-up.And no evidence of increased risk of stroke.