Primary percutaneous coronary interventions in patients with ST-segment elevation myocardial infarction complicated by «no-reflow» phenomenon
- Authors: Iskhakov MM1, Sayfullin RR1, Yagafarov IR1, Khatypov MG1, Gazizov NV1, Nugaybekova LA2, Sayfutdinov RG1,2
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Affiliations:
- Medical and sanitary unit of JSC «Tatneft» and the city of Almetyevsk, Almetyevsk, Russia
- Kazan State Medical Academy, Kazan, Russia
- Issue: Vol 96, No 3 (2015)
- Pages: 325-329
- Section: Theoretical and clinical medicine
- Submitted: 28.03.2016
- Published: 15.06.2015
- URL: https://kazanmedjournal.ru/kazanmedj/article/view/1658
- DOI: https://doi.org/10.17750/KMJ2015-325
- ID: 1658
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Full Text
Abstract
Aim. To study the association of «no-reflow» phenomenon incidence and the method of primary percutaneous coronary intervention for ST-segment elevation acute myocardial infarction, and to determine the optimal tactics for primary coronary intervention.
Methods. A retrospective analysis of 1339 cases of primary percutaneous coronary intervention for ST-segment elevation myocardial infarction performed in the period from January 2008 to June 2013 was executed. Depending on surgery method, all the patients were allocated to four groups: first group - direct stenting (n=483); second group - thromboaspiration before stenting (n=142); third group - balloon angioplasty and stenting using a small-diameter balloon ≤2.0 mm (n=491); fourth group - balloon angioplasty and stenting using a small-diameter balloon and subsequent use of medium and large-diameter balloons ≥2.0 mm (n=223).
Results. «No-reflow» phenomenon was observed in 164 (12.2%) of cases, incliding 34 (7.0%) cases in the first group, 12 (8.4%) cases in the second group, 53 (10.8%) cases in the third group, and with the majority of cases seen in the fourth group - 65 (29.1%). At primary percutaneous coronary intervention, the following incidence of «no-reflow» phenomenon was observed depending on the infarct-related artery: left anterior descending artery - 85 cases (51.82% of the total number), right coronary artery - 51 (31.09%) cases, circumflex artery - 28 (17.07%) cases, and diagonal branch - 1 (0.6%) case.
Conclusion. In primary percutaneous coronary intervention with direct stenting and thromboaspiration before stenting, the incidence of «no-reflow» phenomenon is significantly lower. Patients who undergo primary percutaneous coronary intervention preceded by repeated balloon angioplasty using medium and large-diameter balloons are at higher risk for «no-reflow» phenomenon.
About the authors
M M Iskhakov
Medical and sanitary unit of JSC «Tatneft» and the city of Almetyevsk, Almetyevsk, Russia
Author for correspondence.
Email: marssurgeon@gmail.com
R R Sayfullin
Medical and sanitary unit of JSC «Tatneft» and the city of Almetyevsk, Almetyevsk, Russia
Email: marssurgeon@gmail.com
I R Yagafarov
Medical and sanitary unit of JSC «Tatneft» and the city of Almetyevsk, Almetyevsk, Russia
Email: marssurgeon@gmail.com
M G Khatypov
Medical and sanitary unit of JSC «Tatneft» and the city of Almetyevsk, Almetyevsk, Russia
Email: marssurgeon@gmail.com
N V Gazizov
Medical and sanitary unit of JSC «Tatneft» and the city of Almetyevsk, Almetyevsk, Russia
Email: marssurgeon@gmail.com
L A Nugaybekova
Kazan State Medical Academy, Kazan, Russia
Email: marssurgeon@gmail.com
R G Sayfutdinov
Medical and sanitary unit of JSC «Tatneft» and the city of Almetyevsk, Almetyevsk, Russia; Kazan State Medical Academy, Kazan, Russia
Email: marssurgeon@gmail.com
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