Rescue Angioplasty After Failed Thrombolysis: Technical and Clinical Outcomes in a Large Thrombolysis Trial

摘要: Abstract Objectives. We sought to assess the angiographic outcome, complication rates and clinical features of percutaneous transluminal coronary angioplasty (PTCA) after failed thrombolysis for acute myocardial infarction. Background. “Rescue angioplasty” refers mechanical reopening an occluded infarct-related artery (IRA) intravenous thrombolysis. Although procedure is commonly performed, data describing its technical outcome are sparse. Early reports suggested that rescue PTCA less often successful produces more complications than primary PTCA. Other have described beneficial effects but adverse outcomes when unsuccessful. Methods. Using from Global Utilization Streptokinase Tissue Plasminogen Activator Occluded Coronary Arteries (GUSTO-1) substudy, we compared 198 patients selected a attempt with those 266 managed conservatively and, reference, 1,058 Results. Patients offered had impaired left ventricular function in whom closed vessels were conservatively. Rescue successfully opened 88.4% arteries, 68% attaining Thrombolysis Myocardial Infarction (TIMI) grade 3 flow. The interventions did not increase catheterization laboratory or postprocedural rates. Multivariate analysis identified severe heart failure be determinant attempt. Successful resulted superior 30-day mortality outcomes, comparable IRAs conservatively, favorable thrombolytic therapy was initially successful. rate 30.4%; however, five seven who died cardiogenic shock before procedure. Conclusions. tends predictors poor outcome. It effective restoring patency. die already extremis