Effects of thrombus suction therapy on myocardial blood flow disorders in males with acute inferior myocardial infarction

Several studies have reported that the use of a distal protection device decreases the incidence of slow-flow and/or no-reflow in patients with myocardial infarctions. In the present study, we investigated the influence of aRESCUE/Thrombuster systemandaPercuSurge GuardWire catheter on coronarymicrocirculation disorders in patients with acutemyocardial infarction using the natriuretic polypeptide (ANP), the brain natriuretic peptide (BNP), and Tc-99m-tetrofosmin myocardial scintigraphy (TF). The group consisted of a77patients with initial inferiormyocardial infarction who had undergone emergency coronary angioplasty. The patientswere randomly divided into : Group D (n= 28), inwhich a direct stent alonewas inserted, Group R/T (n= 25), inwhich a stentwas insertedafterRESCUEsystemor aThrombuster system was performed, and Group P (n= 24), in which a stent was inserted after thrombus suction using a PercuSurge GuardWire catheter. Patientswith coronary slow-flow/no-reflow were 3, 2 and 0cases in Group D, Group R /T and Group P, respectively. In the present study, patients with good-reflowwere enrolled in order to investigate the coronarymicrocirculation disorder in patientswith visually similar coronaryblood flow obtained in coronary angiography after percutaneous coronary reperfusion therapy. TF myocardial scintigraphy was performed 10 . 3 days after admission. Bull's eye imageswere divided into 8 sections, and each section was evaluated in 4 grades. The grade of each segment was regarded as the defect score. The resultswere comparedwith the database prepared based on bull's eyemaps from50 healthy adults in our hospital, and count areas of ..SD(standard deviation) or lesswere calculated as the extent score (%), reflecting the area in which myocardial blood flow was decreased. The extent and severity scores in Groups P and R/Twere significantly lower than those in Group D. Coronary angiography at the chronic stage (6 months after surgery) showed the patency of the responsible vascular lesion in all patients. However, the ANP, BNP, cardiac index, and pulmonary capillary wedge pressure (PCWP) were significantly improvedinGroups R/T and P, compared to Group D (p< 0.01). These results suggest that the use of a RESCUE/ Thrombuster system and a PercuSurge GuardWire catheter systemin patientswith acute inferior wall infarction improves coronarymicrocirculation disorders and acute-to chronicphase cardiac function.