LATE ELECTIVE ANGIOPLASTY FOR PATIENTS WITH RESIODUAL STENOSIS AND EVIDENCE OF ISCHEMIA AFTER THROMBOLYTIC TREATMENT OF AMILATE ELECTIVE ANGIOPLASTY FOR PATIENTS WITH RESIODUAL STENOSIS AND EVIDENCE OF ISCHEMIA AFTER THROMBOLYTIC TREATMENT OF AMI
摘要(Abstract)：
<正> Background:Several studies have shown PTCA performed early afterthrombolysis to be unnecessary or even harmful.However,PTCA in these trialswas generally performed 1-3 days aider AMI,when the patient may be unsuitedfor PTCA,and the incidence of major complications was high.We observed theinitial results of dalayed PTCA(7-30 days) in patients with residual stenosis andevidence of iscbemia.Methods and Results:28 patients were eligible for inclusion:1)They hadreceived intravenous thrombolytic therapy within 12 hours of symtom onset ofAMI.2)They had postinfarction angina,or≥1mm fiat or downsloping STsegment depressions or T wave inversions,or the response of segmental wallmotion abnormalities to nitrates or dobutamine.3)They had an infarct-arterystenosis of≥50% diameter stenosis.Mean age was 56±10 yeats.Proceduralsuccess was obtained in 26 patients(92.8%),guidewire could not cross one totalocclusion lesion and balloon could not get through another.Intracoronarystenting was performed in 15 of 26 patients(57.7%).Diameter stenosis wasreduced from 75±12% to 22±10%.In-hospital or parioperativecomplications were as follows:digest tract bleeding,one(3.8%);subacuteclosure,one(3.8%).There was no significant increase in ejection fraction 4-weeks later.There was no reinfarction during the 12 months of follow-up.Cnnclusion:In this selected patient population,late elective PTCA results in alow incidence of in-hospital and parioparative complications.Clinical success,defined by absence of symptoms,appears to be sustained at 1 year.
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