Document Detail


Incomplete lysis of thrombus in the moderate underlying atherosclerotic lesion during intracoronary infusion of streptokinase for acute myocardial infarction: quantitative angiographic observations.
MedLine Citation:
PMID:  3948368     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thrombolytic recanalization of the obstructed coronary lumen was studied in 32 patients receiving intracoronary streptokinase for 60 to 90 min during acute myocardial infarction. The process was viewed at high arteriographic magnification and was quantified with computer-assisted measurements from repeated single-plane views. The variability of the method for this application was 0.15 to 0.18 mm on minimum diameter estimates. Structural details were seen that are not commonly appreciated at conventional magnification. The recanalized lumen appears to form along an interface between the thrombus and the vessel wall, progressively enlarging its minimum arteriographic diameter to 0.65 +/- 0.24 mm (+/- 1 SD) at the end of the short-term infusion of streptokinase reflecting a final percent stenosis of 77 +/- 10%. In nine infarct lesions found patent 5 +/- 3 weeks later, the recanalized lumen further improved an average of 0.34 mm in minimum diameter (p less than .005) and 13% stenosis (p less than .01). A thin film of contrast medium surrounding the obstructing thrombus faintly defined the boundaries of the original atherosclerotic lumen in all but two cases. The "original stenosis" measured 1.25 +/- 0.32 mm in minimum diameter and 56 +/- 14% stenosis when first visualized; it was unchanged throughout the course of infusion of streptokinase. In five patients catheterized 10 +/- 12 weeks before their infarction, the original stenosis averaged 1.15 +/- 0.22 mm in the preinfarct angiogram, as compared with 1.17 +/- 0.23 mm in its faintly defined form during thrombolytic therapy (p = NS). In 10 cases, this original lesion was less than a 50% stenosis, and in 21 cases less than 60%.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
B G Brown; C A Gallery; R S Badger; J W Kennedy; D Mathey; E L Bolson; H T Dodge
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  73     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1986 Apr 
Date Detail:
Created Date:  1986-04-23     Completed Date:  1986-04-23     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  653-61     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography / methods*
Arteriosclerosis / physiopathology*,  radiography
Coronary Vessels / pathology
Fibrinolysis*
Humans
Infusions, Parenteral
Middle Aged
Myocardial Infarction / therapy*
Streptokinase / administration & dosage*
Time Factors
Grant Support
ID/Acronym/Agency:
HL 13517/HL/NHLBI NIH HHS; HL 19451/HL/NHLBI NIH HHS
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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