Document Detail


Combined medical and mechanical recanalization in acute myocardial infarction.
MedLine Citation:
PMID:  2931177     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A technique of combined medical and mechanical recanalization was employed in 96 patients with acute transmural myocardial infarction. The mean time between onset of symptoms and admission to hospital was 170 +/- 65 min (X +/- SD). After 10 +/- 16 min, 250,000 U streptokinase was administered intravenously for 20 min. Intracoronary thrombolysis was commenced within 38 +/- 14 min. First coronary angiograms demonstrated reperfusion, an open vessel in 25/96 patients (26%). In 15/71 patients (21%) reperfusion occurred during thrombolysis therapy, before mechanical recanalization could be performed. Recanalization was achieved mechanically in 37/71 patients (52%) with occluded coronary vessels. In 8/71 patients (11%) mechanical recanalization failed but the vessel opened during thrombolysis. In 12/96 patients (12%), the coronary vessel remained occluded. Thus, reperfusion could be achieved in 88% of the patients. Reperfusion rate was 76% in the first 38 patients and 95% subsequently. After reperfusion, coronary thrombi were found in 25/96 patients (26%) but dissolved during thrombolysis in 16/25 patients (64%). Peripheral coronary embolism was observed in 3/25 patients (12%). For the whole group, reocclusion occurred in 8/84 patients (10%). By combined medical and mechanical recanalization, the recanalization rate could be increased with low reocclusion rate. Trends showed an improvement in regional and global left ventricular function in patients with anterior myocardial infarction.
Authors:
R Erbel; T Pop; T Meinertz; W Kasper; G Schreiner; B Henkel; K J Henrichs; C Pfeiffer; H J Rupprecht; J Meyer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Catheterization and cardiovascular diagnosis     Volume:  11     ISSN:  0098-6569     ISO Abbreviation:  Cathet Cardiovasc Diagn     Publication Date:  1985  
Date Detail:
Created Date:  1985-11-01     Completed Date:  1985-11-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7508512     Medline TA:  Cathet Cardiovasc Diagn     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  361-77     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon*
Arrhythmias, Cardiac / mortality
Combined Modality Therapy
Coronary Circulation / drug effects
Coronary Disease / therapy
Electrocardiography
Female
Hemodynamics / drug effects
Humans
Infusions, Parenteral
Male
Middle Aged
Myocardial Contraction / drug effects
Myocardial Infarction / mortality,  therapy*
Recurrence
Streptokinase / therapeutic use*
Stroke Volume / drug effects
Chemical
Reg. No./Substance:
EC 3.4.-/Streptokinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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