EFFECT OF LOCAL DELIVERY OF STREPTOKINASE BEFORE PRIMARY PERCUTANEOUS CORONARY INTERVENTION ON MICROVASCULAR PERFUSION IN ACUTE MYOCARDIAL INFARCTION PATIENTS

Document Type : Original Article

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Cardiology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.

Abstract

Background: The established reperfusion treatment for acute myocardial infarction with ST segment elevation is primary percutaneous coronary intervention (PCI). Local Streptokinase delivery before primary percutaneous intervention may further improve myocardial perfusion by removing microvascular thrombus [in situ formed or embolized from proximal site (spontaneously formed or after PCI)] and fibrin.
Aim of the Work: To compare the effect of locally administrating streptokinase prior to primary PCI in patient with AMI and thrombus aspiration on myocardial perfusion.
Patients and Methods: 50 patients presented to Ain Shams University hospital by acute STEMI managed by primary PCI and were divided into two group. Group I (25 patient) received intracoronary streptokinase by Clearway RX drug delivery balloon before PCI while Group II (25 patients) underwent thrombus aspiration before PCI.
Results: The local delivery of strepotokinase via clearway RX drug delivery balloon was linked to improved microvascular reperfusion as post-procedural thrombolysis in myocardial infarction (TIMI) 3 flow, and MBG 3 achieved in 92% of patients compared to 68% of patients of thrombus aspiration group
Conclusion: Local delivery of streptokinase before primary PCI was associated with better microvascular reperfusion compared with primary PCI with thrombus aspiration device.

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