# Sonotrombolyse bij STEMI behandeld met primaire PCI

*geplaatst 2019-06-11 · Algemeen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2019.03.006 · https://hartvaat.nl/2019/06/11/sonotrombolyse-bij-stemi-behandeld-met-primaire-pci/*

Studie naar sonotrombolyse (ultrageluid + microbellen) als adjuvante therapie bij STEMI behandeld met primaire PCI.

## English: Sonothrombolysis in ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention.

This study evaluated sonothrombolysis (high-intensity ultrasound with intravenous microbubbles) as an adjunctive therapy during primary PCI for STEMI, testing whether acoustic cavitation enhances microvascular reperfusion.

## Abstract (original, from the publication)

BACKGROUND: Preclinical studies have demonstrated that high mechanical index (MI) impulses from a diagnostic ultrasound transducer during an intravenous microbubble infusion (sonothrombolysis) can restore epicardial and microvascular flow in acute ST-segment elevation myocardial infarction (STEMI). OBJECTIVES: This study tested the clinical effectiveness of sonothrombolysis in patients with STEMI. METHODS: Patients with their first STEMI were prospectively randomized to either diagnostic ultrasound-guided high MI impulses during an intravenous Definity (Lantheus Medical Imaging, North Billerica, Massachusetts) infusion before, and following, emergent percutaneous coronary intervention (PCI), or to a control group that received PCI only (n = 50 in each group). A reference first STEMI group (n = 203) who arrived outside the randomization window was also analyzed. Angiographic recanalization before PCI, ST-segment resolution, infarct size by magnetic resonance imaging, and systolic function (LVEF) at 6 months were compared. RESULTS: ST-segment resolution occurred in 16 (32%) high MI PCI versus 2 (4%) PCI-only patients before PCI, and angiographic recanalization was 48% in high MI/PCI versus 20% in PCI only and 21% in the reference group (p < 0.001). Infarct size was reduced (29 ± 22 g high MI/PCI vs. 40 ± 20 g PCI only; p = 0.026). LVEF was not different between groups before treatment (44 ± 11% vs. 43 ± 10%), but increased immediately after PCI in the high MI/PCI group (p = 0.03), and remained higher at 6 months (p = 0.015). Need for implantable defibrillator (LVEF ≤30%) was reduced in the high MI/PCI group (5% vs. 18% PCI only; p = 0.045). CONCLUSIONS: Sonothrombolysis added to PCI improves recanalization rates and reduces infarct size, resulting in sustained improvements in systolic function after STEMI. (Therapeutic Use of Ultrasound in Acute Coronary Artery Disease; NCT02410330).

Auteurs: Wilson Mathias, Jeane M Tsutsui, Bruno G Tavares, Agostina M Fava, Miguel O D Aguiar, Bruno C Borges, Mucio T Oliveira, Alexandre Soeiro, Jose C Nicolau, Henrique B Ribeiro, Hsu Po Chiang, João C N Sbano, Abdulrahman Morad, Andrew Goldsweig, Carlos E Rochitte, Bernardo B C Lopes, José A F Ramirez, Roberto Kalil Filho, Thomas R Porter

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2019.03.006. Bijgewerkt 2026-07-03T13:27:10Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.