Sarkis A, Badaoui G, Kassab R, Salamé E, Nahas M, Checrallah E
Service de Cardiologie, Hôtel-Dieu de France, Beyrouth, Liban.
J Med Liban. 1994;42(3):100-4.
The success of thrombolytic therapy for acute myocardial infarction is limited by failure of reperfusing 25% of occluded arteries, bleeding complications in 0.4 to 1% of patients and the possibility of recurrent ischemia. These problems can be overcome by the use of immediate angioplasty without previous thrombolytic therapy. Between February and December 1993, twelve patients (ten men and two women) admitted for acute myocardial infarction were treated by immediate angioplasty. Five patients had a contraindication to thrombolysis and seven had angioplasty as a deliberate choice. Successful recanalisation was obtained in 11 patients (92%) with one reocclusion at 24 hours. Two patients admitted in cardiogenic shock 12 hours after the onset of symptoms died lately with multiorgan failure. Only one case of clinical restenosis was observed and was redilated. In conclusion, immediate angioplasty without prior thrombolytic therapy is a rapid method of revascularisation with minimal risk and good outcome when it is used early after acute myocardial infarction.
25%的闭塞动脉再灌注失败、0.4%至1%的患者出现出血并发症以及复发缺血的可能性。通过直接进行血管成形术而不预先进行溶栓治疗，可以克服这些问题。1993年2月至12月期间，12例因急性心肌梗死入院的患者（10名男性和2名女性）接受了直接血管成形术治疗。5例患者有溶栓治疗的禁忌证，7例患者是特意选择进行血管成形术。11例患者（92%）成功实现再通，其中1例在24小时后再次闭塞。2例在症状发作12小时后出现心源性休克的患者，最终死于多器官功能衰竭。仅观察到1例临床再狭窄病例，并进行了再次扩张。总之，在急性心肌梗死后早期使用时，不预先进行溶栓治疗的直接血管成形术是一种快速的血管重建方法，风险极小且预后良好。
