A Clinical Evaluation of Primary Angioplasty and Stenting in Acute Myocardial Infarction

Abstract

In 1949 the fibrinolytic effect of streptococcal fibrinolysin (streptokinase) was described for the treatment of fibrous, pUl1llent or sanguineous pleural exudations. The effect of this lytic agent in patients with acute myocardial infarction was described by Fletcher in 1958. In the late nineteensevcnties the pathofysiologic mechanism underlying acute myocardial infarction was recognised. In the majority of patients with acute myocardial infarction a completely occluded coronary artery is present at immediate angiography, caused by the formation of a platelet rich thrombus on reptured atherosclerotic plaque. Reperfusion therapy is aimed at removal of this obstructing clot which can be achieved by t1uombolytic agents (given directly into the coronary artery or intrav