Document Detail

Management of failed thrombolysis after acute myocardial infarction: an overview of current treatment options.
MedLine Citation:
PMID:  17079034     Owner:  NLM     Status:  MEDLINE    
Thrombolytic therapy remains the most commonly administered revascularization strategy for patients with ST-elevation myocardial infarctions (STEMI). However, many patients fail to have patent arteries or ST-segment resolution after these therapies. Multiple strategies have been examined to treat these patients with "failed thrombolysis." We examined the existing medical literature regarding treatment of failed thrombolysis including strategies testing repeat thrombolytic therapy and rescue percutaneous coronary intervention. Additional, we reviewed the literature regarding the efficacy of transferring patient for rescue percutaneous intervention and coronary stenting. The impact of contemporary antiplatelet strategies, cardiogenic shock, and coronary bypass surgery was examined. Overall, the management of patients with acute STEMI in whom thrombolytic therapy failed remains a challenging problem. As a result, many different strategies are currently in use. Among these therapeutic interventions, rescue PCI with coronary stenting appears to be superior when it is done in a timely manner by an experienced center.
Cesar E Mendoza; Mehul R Bhatt; Salim Virani; Alan H Schob; Stewart Levine; Alexandre C Ferreira; Eduardo de Marchena
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Publication Detail:
Type:  Journal Article; Review     Date:  2006-10-31
Journal Detail:
Title:  International journal of cardiology     Volume:  114     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2006-12-12     Completed Date:  2007-01-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  291-9     Citation Subset:  IM    
University of Miami, USA.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary
Clinical Trials as Topic
Coronary Artery Bypass
Fibrinolytic Agents / therapeutic use*
Intra-Aortic Balloon Pumping
Myocardial Infarction / drug therapy,  therapy*
Platelet Aggregation Inhibitors / therapeutic use
Recurrence / prevention & control
Shock, Cardiogenic / etiology,  therapy
Thrombolytic Therapy* / adverse effects
Treatment Failure
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Platelet Aggregation Inhibitors

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

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