Primary angioplasty for acute myocardial infarction: the Zwolle approach

Timely restoration of antegrade coronary blood flow by primary angioplasty of the infarct-related vessel of a patient with an acute myocardial infarction results in myocardial salvage and improved survival. The main issues pertinent to the delivery of primary angioplasty therapy are discussed, and the 'Zwolle approach' is described with regard to the prehospital phase, the first 15 min in-hospital, pharmacological therapy, angiography and angioplasty, risk stratification, rehabilitation and secondary prevention.