1 research outputs found
Percutaneous transluminal coronary angioplasty in acute ischemic syndromes
Acute myocardial ischemic syndromes are apparently
related to the underlying pathophysiology leading to the
clinical instability. Depending on the completeness and the
duration of blood deprivation, different clinical syndromes
result, such as sudden death, acute transmural infarction,
nontransmural infarction, or unstable angina. Recent clinical,
angiographic, and pathologic studies have emphasized the
important pathophysiologic link between unstable angina, acute
myocardial infarction, and early postinfarction angina.
The term unstable angina is used for prolonged episodes
of myocardial ischemia at rest in the absence of detectable
myocardial necrosis. However, in the acute situation, when a
patient presents with chest pain and electrocardiographic
signs of ischemia, the distinction between unstable angina and
myocardial infarction is often difficult. The uncertainty of
outcome in a specific patient forces one to provide maximal
treatment. The prime goal of any intervention in this
situation must primarily be the preservation or early
restoration of antegrade flow in the ischemia-related artery,
in order to resolve myocardial ischemia and to prevent
(further) myocardial necrosis, and so to improve both shortand
long-term mortality and morbidity. Despite the latest
substantial improvements in surgical techniques, cardioplegia,
anaesthesia, and postoperative care, there is still no
consensus as to the safety of surgery in the management of
these subsets of patients. As an attractive alternative to
coronary artery bypass surgery, percutaneous transluminal
coronary angioplasty would logically play an important role in
the management of patients with acute myocardial ischemic
syndromes