Rescue PTCA: For Whom and When?

During the early hours of an evolving acute myocardial infarction, thrombolytic therapy can dramatically improve the prognosis of selected coronary patients. Although the necessity for thrombolytic therapy in evolving acute myocardial infarction has become clear, the subsequent use of angioplasty for closed arteries remains controversial To date there is a relative paucity of definitive data, and no results of a randomized study are available. The aim of this review is to summarize our experience and the published studies on rescue PTCA. The cumulative primary success and reocclusion rate for rescute PTCA in which non-fibrinselective agents was used, was 87 % and 14 %, respectively. It was concluded that rescue PTCA should be considered at least for high-risk patients and those who have no more than one angiographic risk factor.