Efficacy of Thrombosuction using the Export Aspiration Catheter before Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction

Background and Objectives：Effective myocardial reperfusion following primary percutaneous coronary intervention for AMI, in lesions with a thrombus, is limited by distal embolization and slow/no reflow phenomenon.We evaluated the safety and efficacy of a thrombus reduction technique, using the export aspiration catheter for thrombosuction prior to primary PCI for AMI.Subjects and Methods：We analyzed 61 AMI patients who had a thrombus burden on angiography, after having undergone primary PCI, either with or without EAC (EAC group; n=31, 24 males, mean ages 54.7±11.8years)(control group; n=31, 20 males, mean ages 65.5±12.2years).After the primary PCI, the angiographic findings and clinical outcomes at 1 and 6 months were recorded.Results：The procedural and angiographic success rates were 100 (31/31) and 93.5 (29/31), and 100 (31/31) and 87.1% (27/31), respectively.After PCI, the recovery rate to TIMI 3 flow was higher in the EAC than the control group (26/31 vs. 20/31, p<0.05), and the corrected TIMI frame count was less in the EAC than the control group (23.9±15.1 vs. 34.8±22.5,p<0.05).However, there were no different in the TIMI perfusion grade between the two groups.Although there was no statistical significance, distal embolization was more commonly observed in control (16.1%, 5/31) than the EAC group (0/31)(p=0.056).There were no differences in the incidences of MACE at 1 (0 vs. 7.7%, p=0.237) and 6 months (6.9 vs. 0%, p=0.500) between two groups.In the 31 patients who underwent successful thrombosuction, gross thrombi were obtained from 25 (80.6%).Conclusion：In AMI, the use of thrombosuction, with EAC prior to PCI, provides a simple, rapid and potentially effective method for removal of the thrombus burden and restoration of coronary flow.(Korean Circulation J 2005;35:172-179) KEY WORDS：Acute myocardial infarction；Percutaneous coronary angioplasty；Thrombus aspiration. 서 론급성 심근경색증에서 풍선 도자나 스텐트를 이용한 일차 적 관동맥 중재술은 혈전용해제와 더불어 현재까지 가장 효과적인 치료 방법으로 알려져 있다.1)2)