Comparison of the Effects of a Distal Embolic Protection Device and an Aspiration Catheter During Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction

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概要

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• Background The beneficial effect of percutaneous coronary intervention (PCI) using stents for acute myocardial infarction (AMI) has already been demonstrated, but there is the problem that mechanical microvascular occlusion can occur because of thrombus/atheroma embolization when the PCI was performed. The aim of the present study was to retrospectively test and compare the effects of an aspiration catheter or distal embolic protection with a distal occlusion balloon catheter to prevent peripheral vascular embolization. Methods and Results The subjects consisted of 135 patients who underwent PCI with stenting within 12 h of the onset of chest pain caused by their first AMI. They were divided into 2 groups; the aspiration group, consisted of 81 consecutively seen patients who underwent aspiration catheter treatment between January 2001 and May 2002, and the distal protection group was the next group of 54 consecutively seen patients treated with a distal protection device between June 2002 and February 2003. The results were as follows. Thrombolysis in Myocardial Infarction (TIMI) score of 3 was obtained significantly more frequently in the distal protection group (94.4%) than in the aspiration group (79.0%). Additionally, the intensity of the cardiac muscle stain (blush score) was evaluated on coronary angiography and the rate of cases showing a blush score of 3, which indicates favorable blood perfusion at the tissue level, in the distal protection group (56.6%) was significantly greater than in the aspiration group (33.3%, p<0.01). The time to peak blood concentration of creatinine kinase was also significantly shorter in the distal protection group. Conclusions The distal embolism protection method is superior to the aspiration method for prevention of embolization after PCI with stenting for AMI, in terms of tissue level reperfusion in myocardial recanalization therapy.

• 社団法人日本循環器学会の論文
• 2004-12-20

著者

• Kaneko Noboru

  Department of Pneumology and Cardiology, Dokkyo Medical University School of Medicine

• Toi Toru

  Department of Cardiology and Pneumology, Dokkyo University School of Medicine

• Taguchi Isao

  Department of Cardiology and Pneumology, Dokkyo University School of Medicine

• Kanaya Tomoaki

  Department of Cardiology and Pneumology, Dokkyo University School of Medicine

• Kaneko Noboru

  Department Of Cardiology And Pneumology Dokkyo University School Of Medicine

• Oida Akitsugu

  Department Of Cardiology Takase Clinic

• Oida Akitugu

  Department Of Cardiology And Pneumology Dokkyo University School Of Medicine

• Ohida Akitsugu

  Department Of Cardiology And Pneumology Dokkyo University School Of Medicine

• Ogawa Kenichi

  Department of Botany, Faculty of Science, Kyoto University

• Taguchi Isao

  Department Of Cardiology And Pneumology Dokkyo Medical University School Of Medicine

• Taguchi I

  Shimane Medical Univ. Izumo Jpn

• Kaneko Noboru

  Department Of Cardiology And Pneumology Dokkyo Medical University School Of Medicine

• Kaneko Noboru

  Department Of Cardiology And Pneumology Dokkyo Medical University

• Hoshi Toshiyasu

  Department of Cardiology and Pneumology, Dokkyo University School of Medicine

• Sugimura Hiroyuki

  Department of Cardiology and Pneumology, Dokkyo University School of Medicine

• Araki Hidehiko

  Department of Cardiology and Pneumology, Dokkyo University School of Medicine

• Ogawa Kenichi

  Departments Of Cardiology And Pneumology Dokkyo University School Of Medicine

• Taguchi Isao

  獨協医科大学 医学部心臓血管肺内科

• Kaneko Noboru

  Department Of Cardiology The Heart Institute Of Japan Tokyo Women's Medical College

• Abe Shichirou

  Department of Cardiology and Pneumology, Dokkyo University School of Medicine

• Toi Toru

  Department Of Cardiology And Pneumology Dokkyo Medical University School Of Medicine

• Abe Shichirou

  Department Of Cardiology And Pneumology Dokkyo Medical University School Of Medicine

• Araki Hidehiko

  Department Of Cardiology And Pneumology Dokkyo University School Of Medicine

• Kanaya Tomoaki

  Department Of Cardiology And Pneumology Dokkyo Medical University School Of Medicine

• Hoshi Toshiyasu

  Department Of Cardiology And Pneumology Dokkyo University School Of Medicine

• Sugimura Hiroyuki

  Department Of Cardiology And Pneumology Dokkyo University School Of Medicine

• Kaneko Noboru

  Heart Institute Of Japan The 1st Dept. Of Pathology Tokyo Women's Medical College

• Kaneko Noboru

  The Heart Institute Of Japan Tokyo Women's Medical College

• Sugimura Hiroyuki

  Department Of Cardiology & Vascular Disease Dokkyo Medical University Nikko Medical Center

• Araki Hidehiko

  Department of Cardiology and Pneumology Dokkyo Medical University School of Medicine

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