title: [Clinical and angiographic results of delayed revascularization by angioplasty or bypass after intravenous thrombolysis in myocardial infarction].
abstract: Between 1988 and 1990, 150 patients treated for an infarction by intravenous thrombolysis underwent coronary arteriography. Sixty seven were managed by revascularisation by angioplasty (n = 49) or bypass (n = 18) more than 48 hours after thrombolysis. In this delayed revascularisation group, the time before initial fibrinolysis was 114 +/- 55 minutes. The artery responsible for the infarction was patent in 88 per cent of cases at 12 +/- 9 days, with ejection fraction being 56 +/- 12 per cent. Indications for revascularisation were: recurrence of angina, Thallium stress test showing redistribution (n = 9), diffuse lesions (n = 11) or tight (greater than 75 per cent) proximal stenosis without vessel wall sequelae (n = 10). Comparison of the bypass and angioplasty groups showed a lower ejection fraction in the former than the latter (47% VS 58%, p less than 0.01), more frequent three-vessel disease (50% VS 6%, p less than 0.01) and more frequent revascularisation of the anterior interventricular (100% VS 37%, p less than 0.01). There were 2 deaths and 5 recurrences of infarction at one year. Follow-up arteriography was performed between at 2 and 6 months in 72% of the patients: 16 had restenosis after angioplasty and 4 occlusion of the graft after bypass. A second revascularisation procedure was necessary 15 times (14 angioplasties, 1 bypass). The outcome after bypass or angioplasty was favourable in 90% of cases in this group of patients exposed to a recurrence of infarction.
authors.affiliation: Clinique Cardiologique, Hôpital Necker, Paris.
authors.forename: X
authors.initials: X
authors.lastname: Tabone
authors.forename: J P
authors.initials: JP
authors.lastname: Metzger
authors.forename: H
authors.initials: H
authors.lastname: Journo
authors.forename: P
authors.initials: P
authors.lastname: Montgermont
authors.forename: C
authors.initials: C
authors.lastname: Le Feuvre
authors.forename: A
authors.initials: A
authors.lastname: Heulin
authors.forename: A
authors.initials: A
authors.lastname: Vacheron
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography; D015906:Angioplasty, Balloon, Coronary; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D013997:Time Factors
vernacular_title: Résultats cliniques et angiographiques de la revascularisation différée par angioplastie ou pontage après thrombolyse intraveineuse dans l'infarctus myocardique.