Аспирационная тромбэктомия при остром инфаркте миокарда через призму критического анализа современных исследований: обзор литературы

Автор: Гергерт Е.С., Пекарский С.Е., Баев А.Е., Тарасов М.Г., Суслов И.В., Гороховский А.А., Султанов С.М., Богданов Ю.И.

Журнал: Патология кровообращения и кардиохирургия @journal-meshalkin

Рубрика: Обзоры

Статья в выпуске: 4 т.28, 2024 года.

Бесплатный доступ

Цель. Оценить данные об эффективности и безопасности аспирационной тромбэктомии и перспективы более частого ее применения в рутинной клинической практике при остром тромбозе коронарных артерий. Методы. Выполнили поиск в базах данных Medline (PubMed), Cochrane Library и Web of Science за период с 2000 по 2024 г. Ключевые слова: “thrombectomy”, “thrombus aspiration”, “thromboaspiration”, “myocardial infarction”. Включали рандомизированные контролируемые испытания, проспективные когортные и регистровые исследования, метаанализы. Исключали экспериментальные исследования, работы с небольшими выборками (менее 50 пациентов), где тромбэктомию проводили без стандартизированных методов или устройств. Критически анализировали критерии эффективности тромбаспирации как таковой, а также оценивали влияние устройства и его дизайна на эффективность и безопасность вмешательства. Результаты. Из 230 результатов поиска в обзор вошли 45 оригинальных публикаций, соответствующих критериям отбора. В большинстве исследований анализ эффективности/безопасности не учитывал того, что приблизительно в 20–30 % случаев аспирационная тромбэктомия из коронарных артерий технически неуспешна, что вполне достаточно для недооценки ее эффективности. Заключение. Вероятной причиной неоднозначных результатов исследований аспирационной тромбэктомии является большая доля случаев технически неуспешной процедуры, при которой не удается получить тромботическое содержимое из аспирационного катетера. Аспирационная тромбэктомия — этиологический метод лечения острого тромбоза коронарных артерий, а оптимизация дизайна тромбаспирационных катетеров и операционной техники может значительно повысить техническую эффективность и полностью раскрыть потенциал данного способа лечения инфаркта миокарда.

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Аспирационная тромбэктомия, инфаркт миокарда с подъемом сегмента ST, острый коронарный синдром, тромбаспирационный катетер, тромбоз коронарных артерий, тромбэкстракция, чрескожное коронарное вмешательство

Короткий адрес: https://sciup.org/142242705

IDR: 142242705 | DOI: 10.21688/1681-3472-2024-4-18-32

Список литературы Аспирационная тромбэктомия при остром инфаркте миокарда через призму критического анализа современных исследований: обзор литературы

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