Sequential intervention procedures after intracoronary thrombolysis; balloon dilatation, bypass surgery, and medical treatment

Meyer, Jürgen; Merx, W; Dörr, R.; Erbel, Raimund; Essen, R. von; Lambertz, H; Bethge, Christian; Schmitz, H. J.; Bardos, P; Minale, C; Messmer, B. J.; Effort, Sven

doi:10.1016/0167-5273(85)90053-1

Cited by 15 publications

(1 citation statement)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…First, PTCA may expedite reperfusion in the 10-35% (19,20) of patients who do not respond, or have delayed or incomplete response, to thrombolysis. Second, PTCA can safely and effectively reduce the underlying stenosis in the majority of cases (19)(20)(21)(22). Whether PTCA should be employed as the primary procedure or only in combination with thrombolytic therapy depends on the experience of the operator and the nature of the obstruction.…”

Section: Acute Myocardial Infarctionmentioning

confidence: 99%

Percutaneous transluminal coronary angioplasty: state of the art and future directions

Roubin

Gruentzig

1985

Int J Cardiac Imag

View full text Add to dashboard Cite

Current developments in the practice of percutaneous transluminal coronary angioplasty concern increasing the safety of the procedure and reducing the incidence of lesion recurrence. Technical improvements and increased operator experience have greatly expanded the indications for the procedure. With experience, success in dilating proximal discrete lesions is now almost absolute. Old, calcified lesions and chronic total occlusions remain the barriers to total success. Careful case selection and expert anaesthesiology and surgical support are paramount in maintaining low complication rates. The largely unpredictable occurrence of acute vessel reclosure in approximately 2% of patients remains the major problem. This complication is usually the result of uncontrolled intimal dissection. These risks are considerably increased in patients with multivessel and diffuse disease and long lesions. Randomized trials are required to determine if such patients are best managed with bypass graft surgery. Early detection of less advanced coronary disease will ultimately lead to the most effective application of PTCA. Lesion recurrence may be reduced, in part, by careful attention to achieving an optimal, initial arteriographic and haemodynamic result. Otherwise, the solution to restenosis will depend on the development of pharmacological agents which prevent the rapid regrowth of atheromatous plaque.

show abstract

Section: Acute Myocardial Infarctionmentioning

confidence: 99%

Percutaneous transluminal coronary angioplasty: state of the art and future directions

Roubin

Gruentzig

1985

Int J Cardiac Imag

View full text Add to dashboard Cite

show abstract

Newer emergency reperfusion techniques in acute myocardial infarction

Carr¹

1988

Cathet. Cardiovasc. Diagn.

View full text Add to dashboard Cite

We have given an overview of the management of the acute myocardial infarction patient utilizing the aggressive reperfusion techniques available today. Anatomic reperfusion rates have been over 95% with the combined methods described. The remaining problems technically are those of earlier reperfusion, methods to enhance myocardial recovery after ischemia, and prevention of restenosis or reocclusion. The use of laser methodology, coronary sinus retroperfusion, partial left heart bypass, and other innovative strategies may improve these results. The introduction of tissue plasminogen activator will affect our approach and will profoundly alter society's expectations of therapeutic success. Still, patients will die from acute myocardial infarction and its complications. The search for a prevention must, therefore, not be overshadowed by our current enthusiasm for reperfusion techniques. Hopefully, our current approach will become a historical footnote as breakthroughs in preventive strategies occur.

show abstract

Percutaneous Transluminal Coronary Angioplasty in Acute Myocardial Infarction With and Without Prior Systemic Fibrinolytic Therapy

Rutsch

Schartl

Schmutzler

1986

Current Problems in PTCA

View full text Add to dashboard Cite

Sequential intervention procedures after intracoronary thrombolysis; balloon dilatation, bypass surgery, and medical treatment

Cited by 15 publications

References 31 publications

Percutaneous transluminal coronary angioplasty: state of the art and future directions

Percutaneous transluminal coronary angioplasty: state of the art and future directions

Newer emergency reperfusion techniques in acute myocardial infarction

Percutaneous Transluminal Coronary Angioplasty in Acute Myocardial Infarction With and Without Prior Systemic Fibrinolytic Therapy

Contact Info

Product

Resources

About