Angiographic and Long-Term Outcomes of “Rescue” Stenting versus PTCA in Failed Thrombolysis in Acute Myocardial Infarction

• Published in: Angiology 2004-03, Vol.55 (2), p.169-176
• Main Authors: Tadros, George M., Islam, M. Ashequl, Mirza, Ayoub, Blankenship, James C., Iliadis, Elias A.
• Format: Article
• Language: English
• Subjects: Angioplasty, Balloon, Coronary; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Coronary Angiography; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Fibrinolytic Agents - therapeutic use; Follow-Up Studies; Humans; Medical sciences; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - therapy; Prospective Studies; Recombinant Proteins - therapeutic use; Stents; Thrombolytic Therapy; Time Factors; Tissue Plasminogen Activator - therapeutic use; Treatment Failure
• ISSN: 0003-3197; 1940-1574
• DOI: 10.1177/000331970405500209

Percutaneous transluminal coronary angioplasty (PTCA), when performed early after clinically failed thrombolysis, improves acute infarct-artery patency in up to 90% of cases. Limited data are available regarding the role of rescue stenting in this setting. From January 1995 to December 1999, the authors studied all consecutive patients treated with rescue PTCA or rescue stenting within 12 hours of onset of chest pain and clinically failed thrombolytic therapy at their institution. Baseline demographic characteristics, infarct-related artery location, lesion class, left ventricular function, and incidence of multivessel disease were similar between groups (23 patients in each group). Preprocedural TIMI flow 0 was more common in PTCA patients (p=0.025). Quantitative coronary analysis revealed similar incidence of calcification, thrombus burden, minimal lumen diameter (MLD), and lesion length between groups. Post-procedural TIMI 3 flow was more common in stent patients; however, this was not statistically significant (p=0.18). Greater final MLD (p