Why the study?
Does early emergency angiography and rescue PTCA restore coronary artery patency in AMI patients after failed thrombolysis?
Does early emergency angiography and rescue PTCA restore coronary artery patency in AMI patients after failed thrombolysis?
Rescue angiography and PTCA after failed thrombolysis is feasible with a high success rate in restoring coronary patency in hemodynamically unstable AMI patients.
Answers are grounded in this paper and cite their sources.
May support rescue PTCA feasibility after failed thrombolysis; hypothesis-generating, should not yet change practice.
Failed thrombolysis in acute myocardial infarction (AMI) patients is associated with a high risk of morbidity and mortality. Rescue or salvage percutaneous transluminal coronary angioplasty (PTCA) in this group of patients is still controversial. We report our experience with early emergency angiography and rescue PTCA in 27 patients who were hemodynamically unstable or had a large area of myocardium at risk after failed thrombolysis. Rescue PTCA was successful in 95% of attempted PTCA. Three patients were referred to emergency CABG. Early 'rescue angiography' with or without rescue PTCA after failed thrombolysis in a selected patient population, is an important tool for early risk stratification and decision-making during the hyperacute phase of AMI, while it may also serve in restoring coronary artery patency of the infarct-related artery with a high success rate.
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Gruberg et al. (1998) studied this question.
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