Management of complicated coronary angioplasty by intracoronary urokinase and immediate re-angioplasty

Catheterization and Cardiovascular Diagnosis
E VernaG Binaghi

Abstract

Percutaneous transluminal coronary angioplasty was complicated by acute coronary occlusion, dissection of the arterial wall, or angiographic evidence of intraluminal thrombosis in 33 high-risk patients from 153 consecutive angioplasty procedures (21.5%). Ten patients (group I) were managed with nitroglycerin (0.2 to 0.4 mg i.c.) and repeated attempts at mechanical guide wire recanalization or dilation, but they did not receive thrombolytic therapy. In the remaining 23 patients (group II), intracoronary urokinase (100,000 to 360,000 U.I.) was administered over 15-20 min after onset of coronary occlusion or thrombosis and continued during attempts at repeated dilation of the stenosis. The incidence of sudden coronary artery occlusion was 70% in group I patients and 52% in group II. The angiographic evidence of thrombus formation was observed in a higher, but not significant, proportion of group II patients (65%) as compared with group I (30%). The incidence of intimal tearing or dissection was similar in the two groups of patients (40 vs. 34.7%). The overall final success rate of the complicated angioplasty series was 48% (6/33). However, the success rate was lower (10%) in group I than in group II patients (10 vs. 65%; P less th...Continue Reading

References

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Citations

Oct 1, 1993·Catheterization and Cardiovascular Diagnosis·L BilodeauG S Roubin
Nov 1, 1992·Journal of the American College of Cardiology·J A AmbroseJ Marshall
Jul 12, 2002·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Marcelo SanmartínFrancisco Calvo
Dec 16, 1993·The American Journal of Cardiology·J A Ambrose
Jun 1, 1992·Chest·A J Tiefenbrunn

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