Öz
Amaç:
Perkutan koroner girişim (PKG), ST yükselmeli miyokard enfarktüsü (STYMI) ile başvuran hastalarda tedavi yöntemidir. PKG’nin en iyi bilinen komplikasyonlarından biri, no-reflow’dur. Çalışmalar, endotel disfonksiyonu ile vasküler yapı angulasyonu nedeniyle bozulmuş vasküler akış arasındaki ilişkiyi göstermiştir. Hemodinamik değişiklikler ile koroner açılanma arasındaki ilişki hakkında bilgimiz olsa da, vasküler geometri ile koroner akım arasındaki hemodinamik değişiklikler açısından ayrıntılı bir analiz eksikliği vardır. Vasküler geometri ile koronerde no-reflow arasındaki ilişkiyi aydınlatmayı amaçladık.
Yöntem:
Hastanemizin PKG veri tabanını gözden geçirdik ve PKG’yi takiben no-reflow gelişen ve buna ek olarak cinsiyet ve yaşı eşleşen 80 normal akım olan hastayı 120 STYMI hastasını kaydettik. Her grup için demografik ve klinik özellikler, laboratuvar değerleri ve iki boyutlu kantitatif koroner anjiyografi ölçümleri değerlendirildi.
Bulgular:
No-reflow hastalarda daha yüksek hipertansiyon ve diabetes mellitus prevalansı vardı. Ek olarak, serum C-reaktif protein seviyeleri, normal akışa sahip hastalara kıyasla no-reflow gelişen hastalarda daha yüksekti (p<0,001). Öte yandan, serum hemoglobin seviyeleri, normal akışa sahip hastalara kıyasla, no-reflow gelişen hastalarda anlamlı olarak daha düşüktü (p<0,001). Üç boyutlu koroner ölçümlere göre, sol ön inen arter (LAD) ve sirkumfleks arterin (CX) hesaplanan çatallanma açısı, kontrol grubuna göre no-reflow grubunda anlamlı olarak daha genişti [110,9° (21,8°) vs. 85,9° (15,8°), p<0,001].
Sonuç:
Verilerimiz, PKG uygulanan STYMI hastalarında LAD-CX’in bifurkasyon açısı ile no-reflow fenomeni arasında güçlü bir ilişki olduğunu gösterdi.
Anahtar Kelimeler: Bifurkasyon açısı, no-reflow, perkutan koroner girişim
Kaynakça
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