[Extended indications for percutaneous coronary interventions after successful thrombolysis].

UNLABELLED: The study compared the efficiency of percutaneous coronary interventions (PCI) into infarction-related coronary artery (IRCA) in high-risk patients with acute myocardial infarction (AMI), that were fulfilled 12-24 hours since the pain syndrome onset or during recurrent ischemic episodes 3 days after successful thrombolysis. In the first group (68 patients) invasive restoration of blood flow was fulfilled in 3 days (at average 48 hours) after AMI onset due to recurrent ischemia. In the second group (56 patients) IRCA recanalization was fulfilled in 12-24 hours (at average 20 hours) since pain syndrome onset due to clinical signs of unfavorable outcome high risk. IRCA recanalization was successful in 91% and 97% of cases in the first and second groups, respectively. In all cases injection of contrast media Ultravist 370 was diagnostically significant and visualized coronary arteries free of adverse events. In control group (conservative treatment) IRCA occlusion or subtotal stenosis was diagnosed in 18% and 39% of cases, respectively; stenosis >75% and <75% - in 27% and 16%, respectively. CONCLUSION: in high-risk patients with AMI percutaneous coronary interventions into IRCA can be effective 12-24 hours after successful thrombolytic therapy.

[Different methods of myocardial revascularization in non-stable stenocardia].

The purpose of the study was to evaluate different methods of myocardial revascularization. Three hundred and twenty-two patients with non-stable stenocardia were divided into two groups: group one consisted of 226 patients with mono-, bi-, or tri-vascular lesion of the coronary arteries (CA), who underwent percutaneous coronary intervention (PCCI) on the symptom-related CA (128 patients) or coronary bypass surgery (CBS) without cardiopulmonary bypass (59 patients); group two consisted of 96 patients with tri-vascular lesion of CA only, who underwent CBS with cardiopulmonary bypass (CPB) (32 patients) or without CPB (52 patients). The rest patients in both groups received drug therapy. The data from the research show that PCCI on the symptom-related CA is the method of choice in most patients, including those with tri-vascular lesion. In cases with extensive isolated stenosis of anterior descendent coronary artery and chronic occlusions preference may be given to CBS without CPB. CBS with CPB is the method of choice in patients with left CA trunk stenosis and left ventricular dysfunction. In this group of patients, CBS without CPB does not lead to complete myocardial revascularization and thus does not make surgery successful.