董海萌,于波

• 1:哈尔滨医科大学附属第二医院心血管内科

摘要(Abstract)：

<正>对于急性ST段抬高型心肌梗死(ST-segment elevation myocardialinfarction,STEMI)患者来说,行直接经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)是一种即刻恢复病变部位血流灌注的有效治疗方法[1]。然而,直接PCI的一个最主要的限制性是其可能会导致血管远端血栓栓塞并且不能够恢复微血管水平的血流。在支架置入前应用手动血栓抽吸将病变部位的血栓移除,将会减少远端闭塞的发

关键词(KeyWords)： 血栓抽吸;经皮冠状动脉介入治疗;主要不良心血管事件;卒中

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金重点项目(81330033);; 国家重点研发计划项目(2016YFC1301100);; 黑龙江省教育厅重点项目(11551z009)

作者(Author): 董海萌,于波

参考文献(References)：

• [1]Keeley EC,Boura JA,Grines CL.Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction:a quantitative review of 23 randomised trials.Lancet,2003,361(9351):13-20.
• [2]Svilaas T,Vlaar PJ,van der Horst IC,et al.Thrombus aspiration during primary percutaneous coronary intervention.N Engl J Med,2008,358(6):557-567.
• [3]Vlaar PJ,Svilaas T,van der Horst IC,et al.Cardiac death and reinfarction af ter 1 year in the thrombus aspiration during percutaneous coronary intervention in acute myocardial infarction study(TAPAS):a 1-year follow-up study.Lancet,2008,371(9628):1915-1920.
• [4]Fr?bert O,Lagerqvist B,Gudnason T,et al.Thrombus aspiration in ST-elevation myocardial infarction in Scandinavia(TASTE trial).A multicenter,prospective,randomized,controlled clinical registry trial based on the Swedish angiography and angioplasty registry(SCAAR)platform.Study design and rationale.Am Heart J,2010,160(6):1042-1048.
• [5]Svilaas T,van der Horst IC,Zijlstra F.Thrombus aspiration during percutaneous coronary intervention in acute myocardial infarction study(TAPAS)-study design.Am Heart J,2006,151:597.e1-597.e7.
• [6]Huang AL,Murphy JC,Shaw E,et al.Routine aspiration thrombectomy improves the diagnosis and management of embolic myocardial infarction.Catheter Cardiovasc Interv,2016,87(4):642-647.
• [7]Kumbhani DJ,Bavry AA,Desai MY,et al.Role of aspiration and mechanical thrombectomy in patients with acute myocardial infarction undergoing primary angioplasty:an updated meta-analysis of randomized trials.J Am Coll Cardiol,2013,62(16):1409-1418.
• [8]Mahmoud KD,Zijlstra F.Thrombus aspiration in acute myocardial infarction.Nat Rev Cardiol,2016,13(7):418-428.
• [9]Fr?bert O,Lagerqvist B,Olivecrona GK,et al.Thrombus aspiration during ST-segment elevation myocardial infarction.N Engl J Med,2013,369(17):1587-1597.
• [10]Lagerqvist B,Fr?bert O,Olivecrona GK,et al.Outcomes 1 year after thrombus aspiration for myocardial infarction.N Engl J Med,2014,371(12):1111-1120.
• [11]Jolly SS,Cairns JA,Yusuf S,et al.Outcomes after thrombus aspiration for ST elevation myocardial infarction:1-year followup of the prospective randomised TOTAL trial.Lancet,2016,387(10014):127-135.
• [12]Barkagan M,Steinvil A,Berchenko Y,et al.Impact of routine manual aspiration thrombectomy on outcomes of patients undergoing primary percutaneous coronary intervention for acute myocardial infarction:a meta-analysis.Int J Cardiol,2016,204:189-195.
• [13]Ong PJ,Wijns WC.Save your blushes and stop routine thrombus aspiration during primary PCI.Eur Heart J,2016,37(24):1899-1901.
• [14]Weipert KF,Bauer T,Nef HM,et al.Use and outcome of thrombus aspiration in patients with primary PCI for acute ST-elevation myocardial infarction:results from the multinational Euro heart survey PCI registry.Heart Vessels,2016,31(9):1438-1445.
• [15]Bhindi R,Kajander OA,Jolly SS,et al.Culprit lesion thrombus burden af ter manual thrombectomy or percutaneous coronary intervention-alone in ST-segment elevation myocardial infarction:the optical coherence tomography sub-study of the TOTAL(thrombectomy versus PCI alone)trial.Eur Heart J,2015,36(29):1892-1900.
• [16]Jolly SS,Cairns J,Yusuf S,et al.Design and rationale of the TOTAL trial:a randomized trial of routine aspiration thrombectomy with percutaneous coronary intervention(PCI)versus PCI alone in patients with ST-elevation myocardial infarction undergoing primary PCI.Am Heart J,2014,167(3):315-321.e1.
• [17]Jolly SS,Cairns JA,Yusuf S,et al.Randomized trial of primary PCI with or without routine manual thrombectomy.N Engl J Med,2015,372(15):1389-1398.
• [18]Sharma V,Jolly SS,Hamid T,et al.Myocardial blush and microvascular reperfusion following manual thrombectomy during percutaneous coronary intervention for ST elevation myocardial infarction:insights from the TOTAL trial.Eur Heart J,2016,37(24):1891-1898.
• [19]Jolly SS,Cairns JA,Yusuf S,et al.Stroke in the TOTAL trial:a randomized trial of routine thrombectomy vs.percutaneous coronary intervention alone in ST elevation myocardial infarction.Eur Heart J,2015,36(35):2364-2372.
• [20]Mancini JG,Filion KB,Windle SB,et al.Meta analysis of the long-term effect of routine aspiration thrombectomy in patients undergoing primary percutaneous coronary intervention.Am JCardiol,2016,118(1):23-31.
• [21]Levine GN,Bates ER,Blankenship JC,et al.2015 ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction:an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction:a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the society for cardiovascular angiography and interventions.Circulation,2016,133(11):1135-1147.
• [22]O'Gara PT,Kushner FG,Ascheim DD,et al.2013 ACCF/AHAguideline for the management of ST-elevation myocardial infarction:executive summary:a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines.Circulation,2013,127(4):529-555.
• [23]Levine GN,Bates ER,Bittl JA,et al.2016 ACC/AHA Guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease:a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines:an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention,2011 ACCF/AHA guideline for coronary artery bypass graft surgery,2012 ACC/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease,2013 ACCF/AHAguideline for the management of st-elevation myocardial infarction,2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes,and 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery.Circulation,2016,134(10):e123-e155.
• [24]Dominguez AC,Bittl JA,El-Hayek G,et al.Meta-analysis of randomized controlled trials comparing percutaneous coronary intervention with aspiration thrombectomy Vs.Conventional percutaneous coronary intervention during ST-segment elevation myocardial infarction.Catheter Cardiovasc Interv,2016,87(7):1203-1210.
• [25]韩雅玲.冠状动脉血栓抽吸临床应用专家共识.中华医学杂志，2017,97(21):1624-1632．
• [26]Sardella G,Mancone M,Bucciarelli-Ducci C,et al.Thrombus aspiration during primary percutaneous coronary intervention improves myocardial reperf usion and reduces infarct size:the EXPIRA(thrombectomy with export catheter in infarct-related artery during primary percutaneous coronary intervention)prospective,randomized trial.J Am Coll Cardiol,2009,53(4):309-315.
• [27]Zia MI,Ghugre NR,Connelly KA,et al.Thrombus aspiration during primary percutaneous coronary intervention is associated with reduced myocardial edema,hemorrhage,microvascular obstruction and left ventricular remodeling.J Cardiovasc Magn Reson,2012,14:19.
• [28]De Luca L,Sardella G,Davidson CJ,et al.Impact of intracoronary aspiration thrombectomy during primary angioplasty on lef t ventricular remodelling in patients with anterior ST elevation myocardial infarction.Heart,2006,92(7):951-957.
• [29]Lee WC,Fang CY,Chen HC,et al.Aspiration thrombectomy and drug-eluting stent implantation decrease the occurrence of angina pectoris one year after acute myocardial infarction.Medicine,2016,95(17):e3426.
• [30]Liu X,Dong P,Xing S,et al.Clinical evaluation of thrombus aspiration combined with tirofi ban in patients with acute myocardial infarction with elective percutaneous coronary intervention.J Int Med Res,2013,41(5):1532-1540.
• [31]Geng T,Zhang JG,Song ZY,et al.Aspiration thrombectomy and intracoronary tirofiban in st-segment elevation myocardial infarction:combination treatment for patients undergoing primary per-cutaneous coronary intervention.Herz,2016,41(8):732-740.
• [32]Fernández-Rodríguez D,Alvarez-Contreras L,Martín-Yuste V,et al.Does manual thrombus aspiration help optimize stent implantation in ST-segment elevation myocardial infarction?World J Cardiol,2014,6(9):1030-1037.
• [33]Stiermaier T,de Waha S,Fürnau G,et al.Thrombus aspiration in patients with acute myocardial infarction:scientific evidence and guideline recommendations.Herz,2016,41(7):591-598.
• [34]Mahmood MM,Watt J,Ahmed JM.Thrombus aspiration during primary percutaneous coronary intervention for acute myocardial infarction:a review of clinical evidence and guidelines.World JCardiol,2015,7(12):889-894.
• [35]Wachtell K,Lagerqvist B,Olivecrona GK,et al.Novel trial designs:lessons learned from thrombus aspiration during STsegment elevation myocardial infarction in scandinavia(TASTE)trial.Curr Cardiol Rep,2016,18(1):11.
• [36]Olivecrona GK,Lagerqvist B,Fr?bert O,et al.Impact of thrombus aspiration during ST-elevation myocardial infarction:a six month composite endpoint and risk of stroke analyses of the TASTE trial.BMC Cardiovasc Disord,2016,16:62.
• [37]Hachinohe D,Jeong MH,Saito S,et al.Clinical impact of thrombus aspiration during primary percutaneous coronary intervention:results from Korea Acute Myocardial Infarction registry.J Cardiol,2012,59(3):249-257.
• [38]Sirker A,Mamas M,Kwok CS,et al.Outcomes from selective use of thrombectomy in patients undergoing primary percutaneous coronary intervention f or ST-segment elevation myocardial infarction:an analysis of the British Cardiovascular Intervention Society/National Institute for Cardiovascular Outcomes Research(BCISNICOR)registry,2006-2013.JACC Cardiovasc Interv,2016,9(2):126-134.
• [39]Hoole SP,Jaworski C,Brown AJ,et al.Serial assessment of the index of microcirculatory resistance during primary percutaneous coronary intervention comparing manual aspiration catheter thrombectomy with balloon angioplasty(IMPACT study):a randomised controlled pilot study.Open Heart,2015,2(1):e000238.
• [40]Onuma Y,Thuesen L,van Geuns RJ,et al.Randomized study to assess the eff ect of thrombus aspiration on fl ow area in patients with ST-elevation myocardial infarction:an optical frequency domain imaging study-TROFI trial.Eur Heart J,2013,34(14):1050-1060.
• [41]García-García HM,Muramatsu T,Nakatani S,et al.Serial optical frequency domain imaging in STEMI patients:the follow-up report of TROFI study.Eur Heart J Cardiovasc Imaging,2014,15(9):987-995.
• [42]Deng SB,Wang J,Xiao J,et al.Adjunctive manual thrombus aspiration during ST-segment elevation myocardial infarction:a meta-analysis of randomized controlled trials.PLo S One,2014,9(11):e113481.
• [43]El Dib R,Spencer FA,Suzumura EA,et al.Aspiration thrombectomy prior to percutaneous coronary intervention in ST-elevation myocardial infarction:a systematic review and metaanalysis.BMC Cardiovasc Disord,2016,16:121.
• [44]Zhang Y,Peng L,Fan YY,et al.Additional manual thrombus aspiration for ST-segment elevation myocardial infarction during percutaneous coronary intervention:an updated meta-analysis.JGeriatr Cardiol,2016,13(4):344-354.
• [45]Elgendy IY,Huo T,Bhatt DL,et al.Response to Letter Regarding Article，“Is Aspiration Thrombectomy Benef icial in Patients Undergoing Primary Percutaneous Coronary Intervention?MetaAnalysis of Randomized Trials”.Circ Cardiovasc Interv,2015,8(10).pii:e003154.
• [46]Jolly SS,James S,Dzavik V,et al.Thrombus aspiration in ST-segment-eleva-tion myocardial infarction:an individual patient meta-analysis:thrombectomytrialists collaboration.Circulation,2017,135(2):143-152．
• [47]Jolly SS,Cairns JA,Lavi S,et al.Thrombus aspiration in patients with highthrombus burden in the total trial.J Am Coll Cardiol,2018,72(14):1589-1596．
• [48]Sim DS,Jeong MH,Ahn Y,et al.Manual thrombus aspiration during primarypercutaneous coronary intervention:impact of total ischemic time.J Cardiol,2017,69(2):428-435．
• [49]Hugelshofer S,Roffi M,Witassek F,et al.Impact of total ischemic time onmanual thrombus aspiration benef it during primary percutaneous coronary inter-vention.Am Heart J,2018,204:34-42.2019-12-16