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Thrombolytic therapy and PTCA in acute myocardial thrombosis

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PTCA An Investigational Tool and a Non-Operative Treatment of Acute Ischemia

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 101))

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Abstract

The role of reperfusion by thrombolytic therapy in patients with evolving myocardial infarction has been established by a large number of trials [1–7]. Myocardial infarction is caused in most patients by thrombotic occlusion of a major coronary vessel. Timely lysis of this thrombus results in salvage of myocardial tissue, preservation of regional myocardial function and thus in improved early- and long-term survival. However, in many patients a severe stenosis remains after thrombolytic therapy which may result in recurrent ischemia, reinfarction, and loss of the initial gain of thrombolysis. PTCA immediately after thrombolysis can reduce this residual stenosis and further improve coronary blood flow [8,9]. Furthermore PTCA can be used to perforate persistent occlusions and reperfuse the myocardium when thrombolysis fails. Thus immediate PTCA would be expected to result in a higher rate of coronary patency then thrombolytic therapy. After PTCA the improved coronary blood flow might further limit infarct size and preserve left ventricular function. Furthermore the rate of recurrent ischemia and reinfarction would be reduced and survival improved. In clinical practice however, these expectations were not fulfilled. In this review the effects of early PTCA in patients with coronary thrombosis on the above mentioned factors are analysed.

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Authors
  1. M. L. Simoons
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  2. P. J. De Feyter
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  3. H. Suryapranata
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Editor information

Editors and Affiliations

  1. Cardiac Catheterization Laboratory, Thorax Center, Erasmus University, Rotterdam, The Netherlands

    Patrick W. Serruys (Professor of Interventional Cardiology) (Professor of Interventional Cardiology)

  2. Department of Cardiology, University Hospital, Kiel, Germany

    Rüdiger Simon (Professor of Cardiology) (Professor of Cardiology)

  3. Academic Unit of Cardiovascular Medicine, Charing Cross and Westminster Hospital, London, UK

    Kevin J. Beatt

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© 1990 Kluwer Academic Publishers, Dordrecht

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Simoons, M.L., De Feyter, P.J., Suryapranata, H. (1990). Thrombolytic therapy and PTCA in acute myocardial thrombosis. In: Serruys, P.W., Simon, R., Beatt, K.J. (eds) PTCA An Investigational Tool and a Non-Operative Treatment of Acute Ischemia. Developments in Cardiovascular Medicine, vol 101. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-0453-8_25

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  • DOI: https://doi.org/10.1007/978-94-009-0453-8_25

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6688-4

  • Online ISBN: 978-94-009-0453-8

  • eBook Packages: Springer Book Archive

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