FREQUENCY OF USE OF MANUAL THROMBASPIRATION IN MYOCARDIAL INFARCTION ACCORDING TO THE DATA OF THREE HOSPITALS OF SAINT PETERSBURG AND LENINGRAD REGION

Background. Manual thrombaspiration (MTA) is an adjunctive option during percutaneous coronary interventions (PCI) in acute coronary syndrome. Materials and methods. A total of 1597 case histories of patients with STEMI were studied. According to the character of the infarct-related artery lesion, the following patient groups were formed according to the coronary data: patients with subocclusive lesion/preservation of antegrade blood flow - 558 people (35%), patients with coronary thrombosis grade TIMI Thrombus Grade (TTG) 1-3 - 253 (16%) people, as well as a group of patients with thrombotic coronary artery occlusion with a degree of intracoronary thrombosis of TTG 4-5 (study group) - 786 (49%) patients. Patients of the study group were performed only primary PCI or PCI with adjunctive manual thrombaspiration. Results. Comparing the frequency of performing MTA in individuals of the study group (patients with thrombotic coronary artery occlusion with the degree of intracoronary thrombosis of TTG 4-5), it turned out that if in 2016 this procedure was performed in 48% of patients who had indications for its use, then in 2017 -only 28.8% (p<0.05). Analyzing data on the frequency of intraoperative and early postoperative complications, we can conclude that MTA in the studied hospitals is not associated with their more frequent development. It should also be noted that such a terrible complication as an intraoperative stroke occurred in the group of patients with MTA and without MTA with the same rate. Conclusion. Obviously, clearer clinical and angiographic criteria for selecting patients for MTA are needed, which will help make this procedure more effective. This thesis was voiced in the recommendations of the European Society of Cardiology of myocardial revascularization in 2018, where manual thrombaspiration is not recommended for use in routine practice, but it was noted that further study of this issue is necessary.

primary percutaneous coronary intervention, myocardial infarction, manual thrombaspiration