Effect of Distal Protection Device on the Microvascular Integrity in Acute Myocardial Infarction During Primary Percutaneous Coronary Intervention

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Background The use of a distal protection device during primary percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) may preserve the microvascular integrity of the myocardium. Methods and Results A total of 58 consecutive patients with AMI, who had undergone primary PCI within 24h after onset, were enrolled (30 patients with the PercuSurge GuardWire^[○!R] System, 28 without). The coronary flow velocity reserve was not different between the 2 groups. In patients with a distal protection device, the post-PCI Thrombolysis In Myocardial Infarction myocardial perfusion grades (TMP) were more favorable (TMP0/1: 13.3%, TMP2: 23.3%, TMP3: 63.4% vs TMP0/1: 35.7%, TMP2: 35.7%, TMP3: 28.6%, p=0.023). These patients also exhibited lower basal and hyperemic microvascular resistance index levels (4.33±2.22 vs 5.55±2.36mmHg・cm^<-1>・s, p=0.047; 2.39±1.40 vs 3.14±1.36mmHg・cm^<-1>・s, p=0.045, respectively), and longer basal diastolic deceleration time (679±273 vs 519±289ms, p=0.035) after PCI. Conclusion Distal protection with the PercuSurge GuardWire^[○!R] system may effectively preserve the microvascular integrity of the myocardium during primary PCI in AMI patients.
社団法人日本循環器学会の論文
2006-09-20