학술대회 안내 사전등록 안내 초록등록 안내 초록등록/관리 숙박및교통 안내


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ǥ : ȣ - 500393   2 
The effects of balloon occlusion and aspiration device during primary percutaneous coronary intervention on infarct size and remodeling: mid-term contrast-enhanced magnetic resonance imaging follow-up
성균관대학교 의과대학 순환기 내과, 삼성서울병원 심장혈관센터¹ 영상의학과² 울산병원 순환기내과³
한주용¹, 최승혁¹ 최진호¹ 최연현² 이일³권현철¹ 이상훈¹ 홍경표¹ 박정의¹
Background: Distal embolization of debris and soluble factors released from plaque during primary percutaneous coronary intervention (PCI) may impede myocardial reperfusion. We investigated whether distal protection with balloon occlusion and aspiration device can reduce infarct size and left ventricular (LV) remodeling by serial analysis of contrast-enhanced magnetic resonance imaging (CE-MRI). Methods: Patients undergoing primary PCI for ST-segment elevation myocardial infarction within 12 hours after symptom onset were randomized to either the distal protection group (n=19) or to the control group (n=20). Infarct size was assessed by delayed hyperenhancement on CE-MRI obtained within 21 days after index procedures and at 6 months after myocardial infarction. LV remodeling was defined as an increase in LV end-diastolic volume ≥20% at 6-month follow-up CE-MRI. Results: Baseline clinical and angiographic characteristics were not significantly different between 2 groups. Angioplasty procedures were fully protected with balloon occlusion and aspiration device in all patients of the distal protection group. Visible debris was retrieved in 18 patients (91%) of the distal protection group. Infarct size was 25.9±7.8% of the left ventricular mass in the distal protection group and 26.1±8.2% in the control group (P=0.93). Perfusion defect size was similar in 2 groups. At 6 months, Infarct size decreased significantly compared with initial CE-MRI, however there was no significant difference in 2 groups (20.8±9.1% in the distal protection group vs 18.5±9.1% in the control group, P=0.51). LV remodeling occurred in 19% and 33% of the distal protection group and the control group, respectively (P=0.43). There was no significant difference in the rate of 6-month MACEs between 2 groups (none in the distal protection group and 20% in the control group, P=0.11). Conclusions: Serial CE-MRI showed that distal protection with balloon occlusion and aspiration device during primary PCI did not reduce infarct size nor prevent LV remodeling.


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