The Results of Delayed Endovascular Intervention in St Elevation Acute Myocardial Infarction Due to Thrombotic Occlusion of Coronary Artery

Azarov, V.; Семитко, П.; Glezer, G A; Ахрамович, В.; Малороев, И.; Мельниченко, С.; Атаров, Ю.; Лебедев, В. Н.

doi:10.15829/1728-8800-2017-1-40-45

Cited by 5 publications

(1 citation statement)

References 16 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Использование ингибиторов IIb/IIIa гликопротеиновых рецепторов приводит к значительному снижению частоты повторной реваскуляризации целевого сосуда, однако не влияет на смертность и частоту повторных ИМ [9]. Отсроченное стентирование не улучшает клинические исходы и ассоциируется с большей частотой реваскуляризации целевого сосуда, но задержка в имплантации стента в течение нескольких суток способствует уменьшению или полной резорбции тромботических масс в ИОКА [10][11][12][13][14].…”

Section: Introductionunclassified

Delayed endovascular surgery in patients with acute ST-segment elevation myocardial infarction due to massive culprit arterial thrombosis in the prevention of slow/no-reflow phenomenon

Азаров

Семитко

Журавлев

et al. 2021

Cardiovasc Ther Prev

Self Cite

View full text Add to dashboard Cite

Aim. To assess whether delayed coronary artery stenting (CAS) can reduce the slow/no-reflow incidence in patients with ST-segment elevation myocardial infarction (STEMI) and massive thrombosis (TTG ≥3) of the infarct-related coronary artery (IRCA) compared with immediate CAS within primary PCI.Material and methods. Out of 3651 primary PCIs performed for acute STEMI in the period from January 2016 to May 2020 at the Mytishchi City Clinical Hospital, the retrospective analysis included 105 patients with massive IRCA thrombosis (TTG ≥3). The patients were divided into two groups: first group (n=55) — delayed CAS, second group (n=50) — immediate CAS. In the immediate CAS group, the PCI procedure ended with routine stent implantation, and in the delayed CAS group, stent implantation was delayed for at least 5 days.Results. In the delayed CAS group in comparison with immediate one, the slow/no-reflow phenomenon developed much less frequently in the form of a significant increase in the prevalence of TIMI 3 flow, better myocardial perfusion of myocardial blush grade (MBG) 2-3 (81,8 vs 64%; odds ratio (OR) 2,53; p=0,039) and ST segment resolution ≥70% (87,3% vs 58%; OR 4,97; p=0,001).Conclusion. Delayed CAS in patients with STEMI with massive thrombosis (TTG ≥3) of IRCA reduces the risk of slow/no-reflow phenomenon and can be considered as a possible alternative treatment vs immediate CAS, provided that stable coronary flow is restored before TIMI 3.

show abstract

Section: Introductionunclassified

Delayed endovascular surgery in patients with acute ST-segment elevation myocardial infarction due to massive culprit arterial thrombosis in the prevention of slow/no-reflow phenomenon

Азаров

Семитко

Журавлев

et al. 2021

Cardiovasc Ther Prev

Self Cite

View full text Add to dashboard Cite

show abstract

Two-Stage Revascularization in Patients with Acute Myocardial Infarction and Massive Coronary Thrombosis

et al. 2019

View full text Add to dashboard Cite

Aim:to investigate safety and angiographic efficacy of two-stage revascularization with percutaneous coronary intervention (PCI) with stenting delayed by one day in patients with acute myocardial infarction (MI) and massive coronary thrombosis.Materials and methods.We included in this study 12 patients with massive infarct related coronary artery thrombus which length was greater than thrice the vessel diameter in the presence of TIMI grade II–III blood flow as detected by coronary angiography (CAG). The emergency PCI was not performed, and conservative antithrombotic therapy continued for 24 hours. After this day, CAG was repeated.Results.Repeat CAG in all patients showed thrombus regression which visually appeared as complete lysis in 8, and partial lysis – in 4 patients. Stenting of residual stenosis was performed in 11 patients without complications. In 1 patient residual stenosis was considered insignificant (<50 %) therefore stenting was not performed. No-reflowphenomenon and recurrent MI were not observed.Conclusion.These data suggest that in patients with massive coronary artery thrombosis conservative antithrombotic therapy for 24 hours followed by repeated CAG and, if required, by stenting of residual stenosis, is safe treatment tactics that might reduce the risk of the no-reflow phenomenon.

show abstract

Comparison of outcomes of coronary artery stenting in acute myocardial infarction due to massive coronary thrombosis

Azarov,

Glezer,

Zhuravlev

et al. 2023

Transplantologiâ (Mosk.)

Self Cite

View full text Add to dashboard Cite

Introduction. Therapy of patients with acute ST-elevation myocardial infarction and massive coronary thrombosis (TTG 3) is a far from solved problem of modern medicine, since often in such patients immediate stent implantation is associated with the development of myocardial hypoperfusion, reducing the long-term prognosis of life.Aim. To evaluate short-term and long-term efficacy and safety of delayed and immediate coronary artery stenting techniques in patients with acute ST-elevation myocardial infarction and massive coronary thrombosis.Material and methods. Comparative study in parallel groups, a total of 153 patients with ST-elevation myocardial infarction and massive coronary thrombosis (TTG 3), 75 patients in the delayed coronary artery stenting group, 78 patients in the immediate coronary artery stenting group. In the immediate coronary artery stenting group, percutaneous coronary intervention was performed in one stage with stent implantation, in the delayed coronary artery stenting group; percutaneous coronary intervention was performed in two stages: the first was achieving TIMI-3 blood flow using a minimally invasive mechanical strategy, the second was control coronary angiography 5-6 days and the decision on the implantation of the stent. The primary endpoint is: the rate of achieving optimal myocardial perfusion according to angiography, the secondary combined endpoint is the rate of major adverse cardiovascular events.Results. In the hospital period, optimal reperfusion (TIMI-3 and MBG 2-3) after the primary procedure was achieved in 88% in the delayed coronary artery stenting group and 69.2% of immediate coronary artery stenting with an advantage in the delayed coronary artery stenting group (p=0.005). Of the 75 patients in the delayed coronary artery stenting group, 38 patients (51%) did not receive a stent in the delayed period due to the insignificance of stenosis on the control coronary angiography. There was no significant difference in the incidence of major adverse cardiovascular events between the groups. In the long-term period, the median follow-up period was 47 months. The frequency of major adverse cardiovascular events was 13.3% in the delayed coronary artery stenting group and 23.1% in the immediate coronary artery stenting group, with a trend towards the advantage in the delayed coronary artery stenting group (p=0.1). Overall mortality (9.3% vs. 11.7%), recurrent myocardial infarction (2.6% vs. 5.1%), target vessel revascularization rate (1.3% vs. 6.4%) were without significant benefit. between subgroups.Conclusion. In patients with ST-elevation myocardial infarction and massive coronary thrombosis, the use of delayed coronary artery stenting gives an advantage in achieving myocardial perfusion after the procedure, and demonstrates a tendency to reduce adverse cardiovascular events in the long-term period.

show abstract

The Results of Delayed Endovascular Intervention in St Elevation Acute Myocardial Infarction Due to Thrombotic Occlusion of Coronary Artery

Cited by 5 publications

References 16 publications

Delayed endovascular surgery in patients with acute ST-segment elevation myocardial infarction due to massive culprit arterial thrombosis in the prevention of slow/no-reflow phenomenon

Delayed endovascular surgery in patients with acute ST-segment elevation myocardial infarction due to massive culprit arterial thrombosis in the prevention of slow/no-reflow phenomenon

Two-Stage Revascularization in Patients with Acute Myocardial Infarction and Massive Coronary Thrombosis

Comparison of outcomes of coronary artery stenting in acute myocardial infarction due to massive coronary thrombosis

Contact Info

Product

Resources

About