[Protection against ischemic damage during percutaneous coronary angioplasty].
Minimizing ischemia during percutaneous transluminal coronary angioplasty (PTCA) may lower the risks of the procedure and enhance the short- and long-term success rates of the procedure. However we have to remember that the effects of pharmacological and mechanical interventions during PTCA may be influenced by the functional status of the myocardium. In man the myocardium supplied by a stenotic coronary artery may have a normal metabolic condition or may be stunned, hibernated or even preconditioned by previous ischemic episodes, while the procedure itself may provoke stunning or preconditioning. Many different drugs have been tested for their efficacy under this clinical setting but we recognize that the prolongation of balloon inflation time, though statistically significant, has never proved to be so large to be clinically relevant. Mechanical antegrade coronary infusion (with either blood or oxygenated fluorocarbons) offers the most reliable method for prolonged periods of myocardial protection during PTCA.
Dipartimento di Medicina Interna, Università degli Studi, Pavia.
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G
Specchia
S
S
Ghio
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E
Bramucci
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L
Angoli
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Raffaghello
S
S
De Servi
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D006321:Heart / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D017202:Myocardial Ischemia / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D009566:Nitrates / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D009566:Nitrates
La protezione del danno da ischemia durante angioplastica coronarica percutanea.