[Coronary recanalization in the acute phase of myocardial infarction].
Early reopening of the infarct-related artery limits infarct size, preserves left ventricular function and reduces short and long term mortality rate. The earlier the reopening, the higher the benefit, the best results being obtained within the first 3 hours, but remaining significant up to 12 hours after onset of symptoms. In addition, complete reperfusion of the infarct-related artery without delay of distal filling enhances the results. Early reopening can be obtained with use of intravenous thrombolysis. The indication of rescue angioplasty in case of failed thrombolysis or of immediate, deferred or elective adjunctive angioplasty after successful thrombolysis remain debated. Contraindications to thrombolysis exist in about 13% of patients, in whom the only solution is direct angioplasty without thrombolysis.
Bassand
J P
JP
Service de cardiologie et urgences cardiovasculaires CHU Saint-Jacques, Besançon.
Vuillemenot
A
A
D017130:Angioplasty; D000075202:Contraindications; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy / Q000601:surgery*; D015425:Myocardial Reperfusion / Q000379:methods*; D015912:Thrombolytic Therapy; D014654:Vascular Patency
Reperméabilisation coronaire à la phase aiguë de l'infarctus du myocarde.