title: [Management of acute myocardial infarction. How improve primary angioplasty?].
abstract: Besides the reduction of the delay for the myocardium reperfusion, the revascularization must be optimized by tools and techniques of percutaneous intervention. These are pharmacological, mechanical and procedural. The appeal to antiGP2b3a can be useful in the cathlab. Its intracoronary administration seems to improve drug efficiency. Among the protection devices against the coronary clot embolism, only thrombectomy by manual aspiration gives an evidence of its efficiency. During the primary angioplasty, the drug eluting stent could to be implanted only for the patients and the lesions with high risk of TLR. In some cases, still difficult to identify, a more controlled revascularization would allow to minimize the reperfusion injury. The radial access, decreasing the rate of haemorrhagic complications, must be preferred in first intention.
authors.affiliation: Polyclinique Les Fleurs, cardiologie et radiologie vasculaire interventionnelle, 83190 Ollioules, France. p.commeau@wanadoo.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Commeau
mesh_terms: D000789:Angina, Unstable / Q000188:drug therapy / Q000601:surgery; D017130:Angioplasty / Q000379:methods*; D006328:Cardiac Catheterization / Q000379:methods; D002404:Catheterization / Q000379:methods; D003131:Combined Modality Therapy; D019468:Disease Management; D054855:Drug-Eluting Stents; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006470:Hemorrhage / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D015201:Meta-Analysis as Topic; D015337:Multicenter Studies as Topic; D009203:Myocardial Infarction / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods*; D015428:Myocardial Reperfusion Injury / Q000209:etiology / Q000517:prevention & control; D009204:Myocardial Revascularization / Q000379:methods*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D017131:Thrombectomy / Q000379:methods; D015912:Thrombolytic Therapy
chemical_list: D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex