Selective infusion of thrombolytic therapy in the acute myocardial infarct-related coronary artery as an alternative to rescue percutaneous transluminal coronary angioplasty

Paul A. Gurbel, Charles J. Davidson, E. Magnus Ohman, Jack E. Smith, Richard S. Stack

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

The management of patients with acute myocardial infarction in whom reperfusion has been unsuccessful with standard dose thrombolytic therapy remains controversial.1 Rescue percutaneous transluminal coronary angioplasty (PTCA) has been associated with a high reocclusion rate after failed intravenous tissue plasminogen activator (TPA) with accompanying high morbidity and mortality.2 It has been postulated that PTCA in the setting of thrombolytic therapy may induce subintimal hemorrhage, which may lead to reocclusion.3 As an alternative method for restoring coronary patency after failed intravenous TPA, we describe the results of selective intracoronary injection of a longer acting thrombolytic agent, without adjunctive PTCA, using an infusion catheter that provides a mechanical jet effect to disrupt the coronary thrombus. Use of this coronary thrombolytic technique was successful in each patient after failed intravenous TPA.

Original languageEnglish
Pages (from-to)1021-1023
Number of pages3
JournalThe American journal of cardiology
Volume66
Issue number12
DOIs
StatePublished - Oct 15 1990
Externally publishedYes

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Coronary Balloon Angioplasty
Thrombolytic Therapy
Tissue Plasminogen Activator
Coronary Vessels
Myocardial Infarction
Fibrinolytic Agents
Reperfusion
Thrombosis
Catheters
Hemorrhage
Morbidity
Injections

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Selective infusion of thrombolytic therapy in the acute myocardial infarct-related coronary artery as an alternative to rescue percutaneous transluminal coronary angioplasty. / Gurbel, Paul A.; Davidson, Charles J.; Magnus Ohman, E.; Smith, Jack E.; Stack, Richard S.

In: The American journal of cardiology, Vol. 66, No. 12, 15.10.1990, p. 1021-1023.

Research output: Contribution to journalArticle

Gurbel, Paul A. ; Davidson, Charles J. ; Magnus Ohman, E. ; Smith, Jack E. ; Stack, Richard S. / Selective infusion of thrombolytic therapy in the acute myocardial infarct-related coronary artery as an alternative to rescue percutaneous transluminal coronary angioplasty. In: The American journal of cardiology. 1990 ; Vol. 66, No. 12. pp. 1021-1023.
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