MICROCIRCULATION IMPAIRMENT IN ENDOVASCULAR PROCEDURES IN ACUTE CORONARY SYNDROME: ASSESSMENT AND PREVENTION
https://doi.org/10.18705/1607-419X-2014-20-3-182-188
Abstract
Background. The article reviews the main clinical trials on the management of acute coronary syndrome (ACS) and approaches to the intracoronary thrombi. The results of the Russian study are also presented. Percutaneous coronary intervention (PCI) is the most effective revascularization method, nowadays has become the preferable therapeutic method in ACS. However, reestablishing blood low in epicardial artery with balloon angioplasty and stenting can be complicated by microvascular damage, primarily due to distal embolization. Preventive procedures could help to preserve the microvascular circulation and improve the results of the intervention.
Objective. To assess the impact of bolus infusion of IIb/IIIa receptor inhibitor (Eptiibatide) on the microcirculation in PCI.
Methods. Seventy one patients with ACS underwent primary PCI and traditional intravenous or intracoronary bolus of of IIb/IIIa receptor inhibitor was performed. The TIMI grade low, corrected TIMI frame count, myocardial blush and ST segment resolution were measured after coronary low restoration, after Eptiibatide bolus administration and after coronary stenting.
Conclusions. Selective, intracoronary bolus administration of IIb/IIIa receptor inhibitor is a safe and highly effective method contributing to better thrombus desagregation and preventing distal embolization and microcirculation impairment in ACS patients undergoing PCI.Результаты. Представлены результаты обследования 71 больного ОКС, у которых сравнивалось интракоронарное и внутривенное введение болюсной дозы эптифибатида (Интегрилина) при выполнении ЧКВ. Выводы. Селективное, интракоронарное введение болюсной дозы ингибитора рецепторов IIb/IIIa эптифибатида является безопасным, позволяет достичь максимальной концентрации препарата в зоне коронарного тромбоза и способствует дезагрегации свежего тромба и предотвращает развитие дистальной эмболии с поражением микроциркуляторного русла при выполнении ЧКВ больным ОКС.
About the Authors
B. A. Minko
Russian Scientific Center of Radiology and Surgery Technologies, St Petersburg
Russian Federation
Russian Federation
Corresponding author: Russian Scientiic Center of Radiology and Surgery Technologies, Leningradskaya st., 70, Pesochny, St Petersburg, Russia, 197758. Phone: + 7 (812) 784–69–13. E-mail: profminko@yandex.ru (Boris A. Minko, MD, PhD, Professor, the Head of the Laboratory for Functional and Ultrasound Diagnostics, Russian Research Centre for Radiology and Surgical Technologies).
D. V. Teplyakov
Municipal Hospital, St Petersburg
Russian Federation
Russian Federation
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Review
For citations:
Minko B.A., Teplyakov D.V. MICROCIRCULATION IMPAIRMENT IN ENDOVASCULAR PROCEDURES IN ACUTE CORONARY SYNDROME: ASSESSMENT AND PREVENTION. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2014;20(3):182-188. (In Russ.) https://doi.org/10.18705/1607-419X-2014-20-3-182-188
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