авторы:
|
ключевые слова:
|
Аннотация: В настоящей статье представлен клинический случай успешной профилактики дистальной эмболии у пациента с острым инфарктом миокарда с подъемом сегмента ST с помощью комбинации мануальной тромбоаспирации и дистальной протекции. Мы представили собственные данные и данные литературы о возможном дополнительном источнике дистальной эмболии (содержимое полости разрыва атеросклеротической бляшки) после успешной тромбоаспирации во время имплантации стента, что явилось основой применения стратегии комбинации мануальной тромбоаспирации и дистальной защиты. В качестве устройства защиты от дистальной эмболии использовалась система «Emboshield NAV6». Мы описали дизайнерские особенности этого устройства, знание которых поможет более эффективно использовать его в нативных коронарных артериях в подобных ситуациях. Список литературы 1. Mehta R.H., Harjai K.J., Boura J. et al., for the Primary Angioplasty in Myocardial Infarction (PAMI) Investigators. Prognostic significance of transient no-reflow during primary percutaneous coronary intervention for ST-elevation acute myocardial infarction. Am. J. Cardiol. 2003; 92: 1445-1447. 2. Niccoli G., Burzotta F., Galiuto L. et al. Myocardial no-reflow in humans. J. Am Coll. Cardiol. 2009: 21: 281-292. 3. Piana R.N., Paik G.Y., Moscucci M. et al. Incidence and treatment of «no-reflow» after percutaneous coronary intervention. Circulation. 1994; 89: 2514-2518. 4. Klonner R.A., Ganote C.E., Jennings R.B. The «no-reflow» phenomenon after temporary coronary occusion in the dog. J. Clin. Invest. 1974: 54: 1496-1508. 5. Al'biero R. Oslozhnenija pri chreskozhnyh koronarnyh vmeshatel'stvah: ot prognoza k preduprezhdeniju i lecheniju. Rentgenojendovaskuljarnaja hirurgija ishemicheskoj bolezni serdca: Rukovodstvo po rentgenojendovaskuljarnoj hirurgii serdca i sosudov: V 3 t. (Pod red. L.A. Bokerija, B.G. Alekjana). M.: NCSSH im. A.N. Bakuleva RAMN. 2008; 3: 157-174 [In Russ]. 6. Burzotta F., Trani C., Romagnoli E. et al. Manual thrombus-aspiration improves myocardial reperfusion: the randomized evaluation of the effect of mechanical reduction of distal embolization by thrombus-aspiration in primary and rescue angioplasty (REMEDIA) trial. J. Am Coll. Cardiol. 2005; 46: 371-376. 7. The Thrombolysis in Myocardial Infarction (TIMI) trial, phase I findings: TIMI Study Group. N. Engl. J. Med. 1985; 312: 932-936. 8. Kirma C., Izgi A., Dundar C. et al. Clinical and procedural predictors of no-reflow phenomenon after primary percutaneous coronary interventions. Experience at a Single Center. Circ. J. 2008; 72: 716-721. 9. Zalewski J., Bogaerts K., Desmet W. et al. Intraluminal thrombus in facilitated versus primary percutaneous coronary intervention: an angiographic substudy of the ASSENT-4 PCI (Assessment of the Safety and Efficacy of a New Treatment Strategy With Percutaneous Coronary Intervention) trial. J. Am. Coll. Cardiol. 2011; 57: 1867-1873. 10. Svilaas T., Vlaar P.J., van der Horst I. et al. Thrombus aspiration during primary percutaneous coronary intervention. N. Engl. J. Med. 2008; 358: 557-567. 11. Vlaar P.J., Svilaas G., van der Horst. et al. Cardiac death and reinfarction after 1 year in the Thrombus aspiration during primary percutaneous coronary intervention in Acute myocardial infarction Study (TAPAS): a 1 - year follow - up study. Lancet. 2008; 371: 1915-1920. 12. Guidelines on myocardial revascularization. The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur. Heart J. 2010; 31: 2501-2555. 13. Lee S.Y., Mintz G.S., Kim S.Y. et al. Attenuated plaque detected by intravascular ultrasound: clinical, angiographic, and morphologic features and post-percutaneous coronary intervention complication in patients with acute coronary syndromes. J. Am. Coll. Cardiol. 2009; 2(1): 65-72. 14. Okura H., Taguchi H., Kubo T. et al. Atherosclerotic plaque with ultrasonic attenuation affects coronary reflow and infarct size in patients with acute coronary syndrome: an intravascular ultrasound study. CircJ.2007; 71: 648-653. 15. Isshiki T., Kozuma K., Kyono H. et al. Initial clinical experience with distal embolic protection using «Filtrap’», a novel filter device with a self-expandable spiral basket in patients undergoing percutaneous coronary intervention. Cardiovasc. Intern and Ther. 2011; 26: 12-17. 16. Markas'jan A.V., Petrushenko A.E., Val'ko A.S. i dr. Uspeshnaja aspiracija vnutrikoronarnyh trombov cherez provodnikovyj kateter HEARTRAIL II pri ostrom infarkte miokarda s pod#emom segmenta ST: tri klinicheskih sluchaja. Vest. rentgen. i radiol. 2012; 1: 38-44 [In Russ]. 17. Hadi H.M., Fraser D.G., Mamas M.A. Novel use of the Heartrail catheter as a thrombectomy Device. J. Invas. Cardiol. 2011; 23 (1): 35 - 40. 18. Porto I., Choudhury R.P., Pillay P. et al. Filter no reflow during percutaneous coronary interventions using the Filterwire distal protection device. Int. J. Cardiol. 2006; 109: 53-58. 19. Wu X., Mintz G.S., Xu K. et al. The Relationship Between Attenuated Plaque Identified by Intravascular Ultrasound and No-Reflow After Stenting in Acute Myocardial Infarction The HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) Trial. J. Am. Coll. Cardiol. Intv. 2011; 4: 495-502. 20. Endo M., Hibi K., Shimizu T. et al. Impact of ultrasound attenuation and plaque rupture as detected by intravascular ultrasound on the incidence of no-reflow phenomenon after percutaneous coronary intervention in ST-segment elevation myocardial infarction. J. Am. Coll. Cardiol. Intv. 2010; 3: 540-549. 21. Hara H., Tsunoda T., Moroi M. et al. Ultrasound attenuation behind coronary atheroma without calcication: mechanism revealed by autopsy. Acute Cardiac Care. 2006: 8: 110-112. 22. Johnstone E., Friedl S.E., Maheshwari A. et al. Distinguishing characteristics of erythrocyte-rich and platelet-rich thrombus by intravascular ultrasound catheter system. J. Thromb. Thrombolysis. 2007; 24: 233-239. 23. Ohshima K., Ikeda S