TY - JOUR
T1 - Rescue percutaneous coronary intervention after failed fibrinolytic therapy
T2 - Have expectations been met?
AU - Holmes, David R.
AU - Gersh, Bernard J.
AU - Ellis, Stephen G.
PY - 2006/4
Y1 - 2006/4
N2 - Background: Reperfusion therapy for acute myocardial infarction has revolutionized modern cardiovascular care. Methods and Results: Two strategies have been tested widely: fibrinolytic therapy and percutaneous coronary intervention (PCI). Fibrinolytic therapy has the advantage that it can be given in many medical care institutions that do not have immediate access to catheterization laboratories. Unfortunately, in a substantial number of patients, fibrinolytic therapy may not achieve optimal results, and a strategy of rescue or salvage PCI may be undertaken. There is a relative paucity of evidence-based outcomes on which to judge the merits of rescue PCI, although the volume is increasing. Conclusions: At present, several recommendations can be offered: (1) implementation of a policy of rescue PCI requires clear guidelines of patient selection, training of personnel, logistics of patient movement, and outcomes assessment; and (2) there needs to be heightened awareness with a high index of suspicion about the potential failure of fibrinolytic therapy.
AB - Background: Reperfusion therapy for acute myocardial infarction has revolutionized modern cardiovascular care. Methods and Results: Two strategies have been tested widely: fibrinolytic therapy and percutaneous coronary intervention (PCI). Fibrinolytic therapy has the advantage that it can be given in many medical care institutions that do not have immediate access to catheterization laboratories. Unfortunately, in a substantial number of patients, fibrinolytic therapy may not achieve optimal results, and a strategy of rescue or salvage PCI may be undertaken. There is a relative paucity of evidence-based outcomes on which to judge the merits of rescue PCI, although the volume is increasing. Conclusions: At present, several recommendations can be offered: (1) implementation of a policy of rescue PCI requires clear guidelines of patient selection, training of personnel, logistics of patient movement, and outcomes assessment; and (2) there needs to be heightened awareness with a high index of suspicion about the potential failure of fibrinolytic therapy.
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U2 - 10.1016/j.ahj.2005.12.008
DO - 10.1016/j.ahj.2005.12.008
M3 - Review article
C2 - 16569532
AN - SCOPUS:33645221820
SN - 0002-8703
VL - 151
SP - 779
EP - 785
JO - American heart journal
JF - American heart journal
IS - 4
ER -