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Relevant bibliographies by topics / Percutaneous transluminal coronary angioplasty (PCTA)

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Academic literature on the topic 'Percutaneous transluminal coronary angioplasty (PCTA)'

Author: Grafiati

Published: 4 June 2021

Last updated: 2 February 2022

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Journal articles on the topic "Percutaneous transluminal coronary angioplasty (PCTA)"

1

Heinen, A., V. Hossmann, M. Fuchs, F. M. McDonald, J. Kreuzer, H. W. Höpp, V. Hombach, H. Hirche, and G. Arnold. "Hemorheologic and hemodynamic problems to investigate protective intracoronary perfusion through the dilation catheter (DC) during percutaneous transluminal coronary angioplasty (PCTA)1." Clinical Hemorheology and Microcirculation 5, no. 5 (December 22, 2016): 543–54. http://dx.doi.org/10.3233/ch-1985-5519.

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Jeon, H. J., H. B. Lee, J. H. Kim, I. H. Cha, W. H. Suh, and J. E. Park. "Percutaneous Transluminal coronary angioplasty." Journal of the Korean Radiological Society 22, no. 2 (1986): 180. http://dx.doi.org/10.3348/jkrs.1986.22.2.180.

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Thomas, Stephen. "Percutaneous transluminal coronary angioplasty." Elderly Care 9, no. 2 (February 1989): 16–17. http://dx.doi.org/10.7748/eldc.9.2.16.s23.

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Vatne, K., Hans Kristian Pedersen, B. Laake, U. Brodahl, K. Levorstad, and S. Simonsen. "Percutaneous Transluminal Coronary Angioplasty." Acta Radiologica 30, no. 5 (January 1989): 475–79. http://dx.doi.org/10.3109/02841858909175312.

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King, Spencer B. "Percutaneous transluminal coronary angioplasty." Journal of the American College of Cardiology 35, no. 5 (April 2000): 35B—37B. http://dx.doi.org/10.1016/s0735-1097(00)80048-0.

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KINGIII, S. "Percutaneous transluminal coronary angioplasty." Journal of the American College of Cardiology 35, no. 5 (April 2000): 35B—37B. http://dx.doi.org/10.1016/s0735-1097(00)80070-4.

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KING, S. "Percutaneous transluminal coronary angioplasty." Journal of the American College of Cardiology 35, no. 5 (April 2000): 35–37. http://dx.doi.org/10.1016/s0735-1097(00)90019-6.

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Giuliani, Emilio R. "Percutaneous transluminal coronary angioplasty." Journal of the American College of Cardiology 6, no. 5 (November 1985): 992–94. http://dx.doi.org/10.1016/s0735-1097(85)80299-0.

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Page, U. Scott, J. Edward Okies, Leon Q. Colburn, John C. Bigelow, Neal W. Salomon, and Albert H. Krause. "Percutaneous transluminal coronary angioplasty." Journal of Thoracic and Cardiovascular Surgery 92, no. 5 (November 1986): 847–52. http://dx.doi.org/10.1016/s0022-5223(19)35843-x.

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Schneider, Jakob, and Andreas Grüntzig. "Percutaneous Transluminal Coronary Angioplasty:." Pathology - Research and Practice 180, no. 4 (October 1985): 348–52. http://dx.doi.org/10.1016/s0344-0338(85)80104-7.

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Dissertations / Theses on the topic "Percutaneous transluminal coronary angioplasty (PCTA)"

1

Jensen, Jens. "On-line vectorcardiography during coronary angioplasty and unstable coronary artery disease /." Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-4357-5/.

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Craft, Judy Ann. "Potential involvement of Platelet-Derived microparticles during percutaneous transluminal coronary angioplasty." Queensland University of Technology, 2004. http://eprints.qut.edu.au/15946/.

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Coronary artery disease is a leading cause of morbidity and mortality in developed countries. Percutaneous transluminal coronary angioplasty (PTCA) is an important treatment option when intervention is required; namely for patients with relatively severe occlusions. However, adverse events including recurrence of angina pectoris and restenosis of the treated artery limit patient prognosis, with subsequent re-vascularisation often necessary. Platelet activation accompanies PTCA, with platelet adhesion and aggregation involved in thrombus formation during restenosis. During platelet activation, highly coagulant platelet-derived microparticles (PMPs) are formed, and it is likely that these PMPs will also be produced during PTCA. While platelet aggregation inhibitors used during PTCA limit platelet aggregation and decrease the incidence of restenosis, they do not prevent PMPs being formed. PMPs are capable of adhesion and aggregation, and adhere to PTCA treated arteries in an animal model. Therefore, in order to understand the phenomenon of restenosis and its improved limitation, it is necessary to investigate PMP formation during PTCA. The field of PMP study is in its infancy, with conflicting results from the substantial inequities in methods of PMP measurement, which may be exacerbated by PMP heterogeneity. The current literature on this topic is reviewed in Chapter 2, where the PMP surface and possible functions are considered, and the PMP size and morphology examined. To conclude, the relationship between PMPs and PTCA is explored, with a focus on the potential role of PMPs in restenosis. The knowledge deficiencies in this field are highlighted at the conclusion of this chapter. Very little is known regarding the production of PMPs with PTCA. The level of PMPs during PTCA was monitored in paired arterial blood samples obtained from seventy-five patients undergoing the procedure (Chapter 3). A significant increase in PMPs from baseline to completion of PTCA was clearly demonstrated for the first time. This indicated that procoagulant PMPs are produced during PTCA and may contribute to subsequent restenosis. Furthermore, administration of the platelet aggregation inhibitor abciximab to a group of thirty-eight high risk patients limited PMP formation; given that abciximab patients required more rigorous PTCA, the protective benefit of this medication for PMP production is underlined. Although few patients in this study experienced restenosis, it is interesting to note that of those treated with abciximab, all patients suffering subsequent restenosis were revascularised using PTCA. This demonstrates that their occlusions were comparatively mild as the need for coronary artery bypass grafting was avoided, and suggests that minimisation of PMP levels may assist in limiting the progression of severe restenosis. The increased peripheral level of PMPs predicated investigation of the coronary circulation to determine local events. Although the level of PMPs increased significantly within the coronary arteries of PTCA patients, there was no corresponding increase in the coronary sinus (Chapter 4). This important finding indicated that significant levels of PMPs remained within the coronary circulation, where their ability to adhere, aggregate and accelerate haemostasis may allow them to contribute directly to restenosis. During the time when increased levels of PMPs were being formed, there was no evidence of platelet lysis, which refuted the hypothesis that PMPs are merely membrane fragments of lysed platelets. A wide variation in reported PMP sizes has contributed to the hypothesis that PMPs are heterogeneous. As morphological information can assist in understanding physiology, the final study was designed to investigate platelet morphology from PTCA patients (Chapter 5). Most platelets were activated prior to and following PTCA, with a slight decrease in body size occurring due to PTCA, presumably due to loss of cytoplasm in PMPs being shed as reported in the previous chapter. Importantly, platelet distal pseudopod buds were observed, and these did not alter significantly with PTCA. These buds were probably unformed PMPs, although the exact mechanism of PMP formation remains undetermined. The platelet pseudopods were longer and significantly thinner distally with PTCA, which may be due to movement of cytoplasm into these terminal swellings. In addition, buds or swellings directly on the platelet body were smaller following PTCA, and it is likely these may also be PMPs prior to detachment from the parent platelet. This work has contributed substantially to knowledge of PMPs produced during PTCA. The level of PMPs increased significantly in peripheral arterial samples, with the platelet aggregation inhibitor abciximab preventing this occurrence. This may indicate that functional aggregation receptors are an essential requirement for PMP formation under these conditions. However, it is possible for PMPs to be formed when aggregation is inhibited, and therefore the molecular mechanisms of PMP formation remain unconfirmed. The examination of PMPs from the coronary circulation provided valuable data indicating that PMPs are produced during PTCA but remain within the coronary circulation. As PMPs are capable of adhesion and aggregation, this strongly suggests that PMPs within the coronary circulation would contribute directly to pathogenesis of restenosis, although further investigation on PMPs with PTCA is necessary to confirm this association. The examination of platelet morphology during PTCA indicated that platelets possessed terminal pseudopod swellings, and cell surface swellings. Importantly, the terminal swellings, which are likely to be unformed PMPs, were observed for the first time during PTCA.

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Olbrich, Tom. "Measurement of mechanical wall properties from percutaneous transluminal coronary angioplasty balloon catheters." Thesis, University of Newcastle Upon Tyne, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.248308.

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Feuillâtre, Hélène. "Détermination automatique de l'incidence optimale pour l'observation des lésions coronaires en imagerie rotationnelle R-X." Thesis, Rennes 1, 2016. http://www.theses.fr/2016REN1S039/document.

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Les travaux de cette thèse s’inscrivent dans le cadre du planning de traitements minimalement invasifs des lésions des artères coronaires. Le cardiologue réalise un examen coronarographique, puis dans la continuité, une angioplastie transluminale. L’angiographie rotationnelle à rayons X permet de visualiser sous différentes incidences 2D la lumière des artères coronaires sur plusieurs cycles cardiaques et aussi d’obtenir une reconstruction 3D+T des arbres coronaires. A partir de cette séquence, notre objectif est de déterminer automatiquement une incidence optimale 2D du segment sténosé compatible avec les angles du C-arm afin d’aider le cardiologue lors de l’intervention.Différentes étapes sont considérées pour calculer la position angulaire optimale du C-arm. Afin de suivre la zone de lésion durant le cycle cardiaque, une première méthode est proposée pour mettre en correspondance tous les arbres de la séquence 3D+T. Tout d’abord, un appariement deux à deux des arbres successifs est réalisé afin de construire un arbre d’union. Ces derniers sont ensuite fusionnés afin d’obtenir un arbre mosaïque représentant l’arbre le plus complet de la séquence. L’utilisation de mesures de similarités géométriques et hiérarchiques ainsi que l’insertion de nœuds artificiels permet de prendre en compte les différents mouvements non-rigides des artères coronaires subits au cours du cycle cardiaque et les variations topologiques dû à leurs extractions. Cet appariement nous permet de proposer une deuxième méthode afin d’obtenir une vue angiographique 2D optimale de la zone de lésion tout le long du cycle cardiaque. Cette incidence est proposée spécifiquement pour trois types de région d’intérêt (segment unique, segment multiple ou bifurcation) et est calculée à partir de quatre critères (raccourcissement, chevauchement interne et externe ou angle d’ouverture de bifurcation). Une vue 2D déployée du segment projeté avec le moins de superposition avec les structures vasculaires avoisinantes est obtenue. Nous donnons également la possibilité au cardiologue d’avoir une incidence optimale privilégiant soit le déploiement du stent ou soit le guidage d’outils de la racine de l’arbre à la zone sténosée. Nos différents algorithmes ont été évalués sur une séquence réelle de 10 phases segmentées à partir d’un CT et de 41 séquences simulées
The thesis work deals with the planning of minimally invasive surgery of coronary artery lesions. The physician performs a coronarography following by a percutaneous transluminal angioplasty. The X-ray rotational angiography permits to visualize the lumen artery under different projection angles in several cardiac cycles. From these 2D projections, a 3D+T reconstruction of coronary arteries can be obtained. Our goal is to determine automatically from this 3D+T sequence, the optimal angiographic viewing angle of the stenotic segment. Several steps are proposed to compute the optimal angular position of the C-arm. Firstly, a mosaic-based tree matching algorithm of the 3D+T sequence is proposed to follow the stenotic lesion in the whole cardiac cycle. A pair-wise inexact tree matching is performed to build a tree union between successive trees. Next, these union trees are merged to obtain the mosaic tree which represents the most complete tree of the sequence. To take into account the non-rigid movement of coronary arteries during the cardiac cycle and their topology variations due to the 3D reconstruction or segmentation, similarity measures based on hierarchical and geometrical features are used. Artificial nodes are also inserted. With this global tree sequence matching, we propose secondly a new method to determine the optimal viewing angle of the stenotic lesion throughout the cardiac cycle. This 2D angiographic view which is proposed for three regions of interest (single segment, multiple segment or bifurcation) is computed from four criteria: the foreshortening, the external and internal overlap and the bifurcation opening angle rates. The optimal view shows the segment in its most extended and unobstructed dimension. This 2D view can be optimal either for the deployment of the stent or for the catheter guidance (from the root to the lesion). Our different algorithms are evaluated on real sequence (CT segmentation) and 41 simulated sequences

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Nowinski, Karolina J. "Ventricular repolarization in the human heart : effects of pharmacological and non-pharmacological interventions /." Stockholm : [Karolinska institutets bibl.], 2001. http://diss.kib.ki.se/2001/91-7349-069-5/.

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Konneh, Matthew Kwame. "An investigation of the mechanisms in the intimal response to balloon injury." Thesis, Queen Mary, University of London, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.244030.

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Bose, Jolly. "Percutaneous transluminal coronary angioplasty (PTCA) in the treatment of coronary artery disease in Hong Kong : procedural success, complications and long-term follow-up /." Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B2084282X.

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Macfarlane, Robert. "A study on the short-term cognitive outcome of percutaneous transluminal coronary angioplasty with intra-coronary stenting." Master's thesis, University of Cape Town, 2006. http://hdl.handle.net/11427/11797.

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Includes bibliographical references (leaves 23-26).
This study explores the short term cognitive outcome of percutaneous transluminalcoronary angioplasty with intra-coronary stenting. Participants were assessed cognitively using specific neuropsychological tests used to measure performance in the seven cognitive domains. Forty people took part in the study, with twenty of them making up the stented group, and twenty of them making up the control group. The stented group were assessed a few days before, and then a few weeks after their procedures. The control group were simply assessed whenever they agreed to participate, and then again a few weeks later. There were ten males and ten females in each group. The participants were all between the ages of 34 and 75, and the sample had an average age of 57. The researchers were given access to patients at Groote Schuur Hospital and Gatesville Medical Centre. Analysis of variance was used in order to assess differences between the groups with respect to changes in cognitive performance in all seven cognitive domains. Results indicated that there were not significant differences between the groups, with respect to changes in cognitive performance between the first and second interviews.

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Snyder, Sharon L. "The effect of a percutaneous transluminal coronary artery education booklet on patients' knowledge." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/277268.

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The purpose of this study was to determine if a written patient education booklet would produce an increase in knowledge of adult participants. Thirty subjects were admitted to this quasi-experimental, post-test only study. Subjects in the experimental group (n = 16) were given a patient education booklet, "PTCA--A Patients' Guide," before angioplasty and an Evaluation Questionnaire after angioplasty. Both groups were given a Knowledge Questionnaire after angioplasty. The Student's t-test of independent group means resulted in a non-significant t-value. No difference in knowledge test scores was found between patients who received the booklet and patients who did not receive the booklet. Results from the evaluation questionnaire suggest that subjects perceived the booklet and pictures to be helpful as preparation for angioplasty. Therefore, revision of the PTCA Knowledge Questionnaire and refinement of the study design is suggested.

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Saleh, Nawsad. "The role of C-reactive protein in percutaneous coronary intervention /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-947-1/.

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Books on the topic "Percutaneous transluminal coronary angioplasty (PCTA)"

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1945-, Holmes David R., ed. PTCA, percutaneous transluminal coronary angioplasty. Philadelphia: Davis, 1987.

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Erlichman, Martin. Patient selection criteria for percutaneous transluminal coronary angioplasty. Rockville, MD: National Center for Health Services Research and Health Care Technology Assessment, U.S. Dept. of Health and Human Services, Public Health Service, 1985.

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Erlichman, Martin. Patient selection criteria for percutaneous transluminal coronary angioplasty. Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, National Center for Health Services Research and Health Care Technology Assesment ; Springfield, VA : Available from National Technical Information Service, 1985.

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Inc, Medical Data International. U.S. markets for percutaneous transluminal coronary angioplasty and coronary stent products. Santa Ana, Calif.]: Medical Data International, 2002.

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Insight, LLC Medtech. European markets for percutaneous transluminal coronary angioplasty and coronary stenting products. Newport Beach, CA: Medtech Insight, 2005.

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Guide to coronary angioplasty and stenting. Amsterdam: Harwood Academic Publishers, 1998.

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Rowe, Michael. Angioplasty and other percutaneous interventional techniques in the treatment of ischaemic heart disease: A literature review. [Canberra]: Australian Institute of Health, 1989.

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Vetrovec, George W. Coronary angiography for the interventionalist. New York: Chapman & Hall, 1994.

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Szlavy, Laszlo. Noncoronary angioplasty and interventional radiologic treatment of vascular malformations. Baltimore: Williams & Wilkins, 1995.

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10

Stammen, F. Percutaneous Transluminal Coronary Angioplasty. Leuven University Press, 1994.

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Book chapters on the topic "Percutaneous transluminal coronary angioplasty (PCTA)"

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Leimgruber, P., and A. R. Grüntzig. "Percutaneous transluminal coronary angioplasty." In Invasive Cardiovascular Therapy, 184–89. Dordrecht: Springer Netherlands, 1987. http://dx.doi.org/10.1007/978-94-009-4293-6_16.

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Kober, G., C. Vallbracht, R. Hopf, B. Kunkel, and M. Kaltenbach. "Effect of Percutaneous Transluminal Coronary Angioplasty." In Secondary Prevention in Coronary Artery Disease and Myocardial Infarction, 261–68. Dordrecht: Springer Netherlands, 1985. http://dx.doi.org/10.1007/978-94-009-5024-5_27.

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Boulay, F., P. David, P. R. David, and M. G. Bourassa. "Work Status and Percutaneous Transluminal Coronary Angioplasty." In Return to Work After Coronary Artery Bypass Surgery, 183–90. Berlin, Heidelberg: Springer Berlin Heidelberg, 1985. http://dx.doi.org/10.1007/978-3-642-69855-2_25.

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Schwarz, F. "Percutaneous Transluminal Coronary Angioplasty in Unstable Angina." In Reperfusion and Revascularization in Acute Myocardial Infarction, 174–75. Berlin, Heidelberg: Springer Berlin Heidelberg, 1988. http://dx.doi.org/10.1007/978-3-642-83544-5_23.

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Rapaport, E. "Discussion: Session III — Percutaneous Transluminal Coronary Angioplasty." In Reperfusion and Revascularization in Acute Myocardial Infarction, 188–96. Berlin, Heidelberg: Springer Berlin Heidelberg, 1988. http://dx.doi.org/10.1007/978-3-642-83544-5_25.

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Bourassa, M. G., P. R. David, R. Bonan, D. O. Williams, R. Holubkov, S. F. Kelsey, and K. M. Detre. "Percutaneous Transluminal Coronary Angioplasty After Myocardial Infarction." In Developments in Cardiovascular Medicine, 145–56. Boston, MA: Springer US, 1988. http://dx.doi.org/10.1007/978-1-4613-2021-0_11.

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Riess, H. "Platelets, Prostanoids and Percutaneous Transluminal Coronary Angioplasty." In Current Problems in PTCA, 67–74. Heidelberg: Steinkopff, 1986. http://dx.doi.org/10.1007/978-3-642-72407-7_8.

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Brooks, Alrick. "The Patient for Percutaneous Transluminal Coronary Angioplasty." In Preanesthetic Assessment 2, 33–44. Boston, MA: Birkhäuser Boston, 1989. http://dx.doi.org/10.1007/978-1-4684-6765-9_4.

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Alber, G., and O. Bosse. "Percutaneous Transluminal Coronary Angioplasty with Dislocated Cardiac Surgery." In Coronary Artery Surgery in the Nineties, 111–15. Berlin, Heidelberg: Springer Berlin Heidelberg, 1987. http://dx.doi.org/10.1007/978-3-642-45622-0_19.

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Visser, Cees A., and Gerard Kan. "Echo-Doppler Cardiography during Percutaneous Transluminal Coronary Angioplasty." In Developments in Cardiovascular Medicine, 45–49. Boston, MA: Springer US, 1988. http://dx.doi.org/10.1007/978-1-4613-1767-8_4.

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Conference papers on the topic "Percutaneous transluminal coronary angioplasty (PCTA)"

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Tavilla, A. C., D. Nicolis, D. Surder, T. Moccetti, and I. Stefanini. "X-rays transparent resuscitator system for percutaneous transluminal coronary angioplasty." In 2015 E-Health and Bioengineering Conference (EHB). IEEE, 2015. http://dx.doi.org/10.1109/ehb.2015.7391415.

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Mironova, T. F., and V. A. Mironov. "Heart rate variability under endogenous intoxication before and after percutaneous transluminal coronary angioplasty in patients with angina pectoris." In MECHANICS, RESOURCE AND DIAGNOSTICS OF MATERIALS AND STRUCTURES (MRDMS-2018): Proceedings of the 12th International Conference on Mechanics, Resource and Diagnostics of Materials and Structures. Author(s), 2018. http://dx.doi.org/10.1063/1.5084404.

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Yu, Mei, and Ian Grosse. "Prediction of Mechanical Behavior of Balloon-Expandable Stents." In ASME 2004 International Mechanical Engineering Congress and Exposition. ASMEDC, 2004. http://dx.doi.org/10.1115/imece2004-59455.

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Coronary heart disease is a major health threat for people in the developed countries. Narrowing of the coronary arteries is one of the most common types of coronary heart diseases and is often treated by percutaneous transluminal coronary angioplasty (PTCA) and recently by stenting. A stenting procedure involves inserting a slotted metal tube or coil into the artery and expanding it to help achieve a sufficient luminal size. To optimize the design of stents, we have developed a finite element model of the stenting procedure. The results showed the distal ends of the stent could damage arteries due to non-uniform expansion of the stent. Our model also showed that inclusion of the plaque and artery is important for predicting the final stent shape and diameter. A response surface of the stent hoop stiffness is proposed to help designers quickly decide the stiffness of the stent for a given design. Results show that contact stresses are inversely proportional to stent stiffness and a minimum stent hoop stiffness is needed to prevent stent collapse after balloon removal.

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La Barck, Anthony J., Jennifer E. Akers, and Thomas L. Merrill. "Tissue Oxygen Transfer During Reperfusion and Post-Conditioning." In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53064.

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Heart disease is the leading cause of death in the United States. Ischemic heart disease occurs when coronary blood flow to the heart is reduced, limiting the amount of oxygen and nutrients the heart receives. When blood flow is restored after a percutaneous transluminal coronary intervention (PCI), rapid reperfusion from sudden balloon deflation can cause further injury to oxygen-starved tissue, leading to increased cell injury and cell death. Studies in animal models with ischemic heart disease have shown that reperfusion injury may account for up to 50% of the final infarct size [1]. Post-conditioning (PC) may reduce the amount of reperfusion injury by applying intermittent periods of ischemia during the early moments of reperfusion. This procedure periodically occludes blood vessels during reperfusion by periodically inflating and deflating an angioplasty balloon according to a specific algorithm. Zhao et al. showed that PC reduced reperfusion injury in a canine model by applying 3 cycles of 30 seconds of reperfusion followed by 30 seconds of ischemia (re-occlusion) at the onset of reperfusion. PC in this study reduced tissue AN/AAR (area of necrosis/area at risk) by 48% [2]. In 2008, Gao et al. demonstrated that the effectiveness of PC in rats was dependent on the number of cycles in the PC algorithm, as well as the durations of the ischemia/reperfusion phases [3].

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Barbash, G. I., H. Hod, S. Rath, Y. Har-Zahav, B. Rabinovitz, and U. Seligsohn. "CYCLES OF REOCCLUSION-REPERFUSION DURING RT-PA TREATMENT IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION (AMI)." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1642976.

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Early reocclusion of reperfused coronary arteries is observed in 20%-45% of AMI patients. Our protocol included: 10 mg rt-PA in bolus and continuous infusion of 50 mg in the 1st hr., 20 mg in the 2nd hr., and 10 mg during each of the following 4 hrs. Concomitantly, heparin 5,000 iu in bolus and continous infusion of 25,000 iu/24hr., and aspirin 250 mg/24hr were given. Five our of 49 patients who had clinical and electrocardiographic signs of reperfusion redeveloped severe chest pain and ST elevation while on 6 hr rt-PA and heparin. Increase of rt-PA infusion rate resulted, within 1-2 min., in resolution of chest pain and normalization of the ST elevation. 2-4 such cycles of reocclusion-reperfusion were observed in each case. In 2 out of these 5 patients stable reperfusion was achieved by administration of the 120 mg rt-PA infusion during 3.5 hr in one, and by repeated full dose protocol in the other. 2 underwent emergency percutaneous transluminal coronary angioplasty (PTCA), but kept reoccluding following several dilatations, and were eventually referred to an emergency bypass operation. 1 patient received the full protocol, but an infarction of the anterior wall was not prevented. Conceivably, there is a subset of patients with AMI in whom the present rt-PA regimen is insufficient, and higher total dose of rt-PA may be more effective.

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Bassand, J. P., J. Machecourt, J. Cassagnes, J. R. Lusson, P. Bourlard, T. Anguenot, J. Faivre, J. E. Wolff, and J. Peycelon. "ACYL PLASMINOGEN STREPTOKINASE VERSUS HEPARIN IN RECENT ACUTE MYOCARDIAL INFARCTION. PRELIMINARY REPORT OF A FRENCH INTERUNIVERSITY TRIAL." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643622.

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One hundred and twenty seven patients (pts) suffering from a first acute myocardial infarction (AMI) were included in a multicenter trial involving three University Hospitals and 22 community Hospitals without catheterization facilities. Patientswere randomly allocated within 5 hours following the onset of symptoms either to acyl plasminogen streptokinase (APSAC) 30 IU within 5 min followed 4 hours later by heparin at a dose of 500 IU/kg/day or to conventional Heparin (H) therapy 500 IU/kg/day. 63 pts received APSAC and 64 received H. Both APSAC and H groups were similar in age, location of AMI, Killip class and time of randomization. After initial therapy Pts were referred to the University Hospitals and submitted between Day 1 and Day 7 to a selective coronary angiography and immediate percutaneous transluminal angioplasty (PTCA) of the infarct-related artery if suitable for the procedure.4 APSAC pts and 2 H pts died during the hospital course (NS).The arterial patency rate determined on average 3.4 ± 1.2 days after the onset of symptoms was 88% in APSAC and 42% in H (P<.001). 15 APSAC pts and7 H pts were submitted to PTC A with one failure in each group. LVEF and akinetic score (AK) were determined from left ventricular angioeraDhy :On Day 14, pts were submitted to Ti 201 scan and to radionuclide angiography (RNA). Results are not yet available.Our results showed that early infusion of APSAC in AMI produced a high short term patency-rate of the IRA with a tendancy toward improvement of the left ventricular systolic function which failed to reach statistical significance because of the relatively small size of the cohort.

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