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Access-site complications after rescue percutaneous coronary intervention during thrombolysis for acute myocardial

A Germing1, M Lindstaedt, S Ulrich

  • 1Medizinische Klinik II, Kardiologie und Angiologie, Berufsgenossenschaftliche Kliniken Bergmannsheil, Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany. alfried.germing@ruhr-uni-bochum.de

Zeitschrift Fur Kardiologie
|January 26, 2005
PubMed

Insights

Emergency coronary interventions after failed thrombolysis are safe, even with aggressive antithrombotic therapy. This study found low rates of access-site bleeding complications in patients undergoing these rescue procedures.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Aggressive antithrombotic therapy can increase access-site complications post-percutaneous coronary intervention (PCI).
  • Emergency PCI is often required after failed thrombolysis for acute myocardial infarction (AMI).
  • Assessing safety of PCI in patients on ongoing thrombolysis is crucial.

Purpose of the Study:

  • To analyze femoral bleeding complications after emergency PCI in patients with unsuccessful thrombolysis for AMI.
  • To evaluate the safety of PCI in patients receiving aggressive antithrombotic regimens.

Main Methods:

  • Retrospective analysis of 76 consecutive patients undergoing emergency PCI within 8 hours of failed thrombolysis.
  • Documented all femoral bleeding complications, including hematomas, pseudoaneurysms, and fistulas.
  • Recorded use of additional antithrombotic agents like heparin and glycoprotein IIb/IIIa inhibitors.

Main Results:

  • Only 3.9% of patients developed minor femoral hematomas; 1.3% required blood transfusion.
  • No cases of pseudoaneurysm, fistula, or surgical vascular intervention were observed.
  • PCI procedures demonstrated excellent safety regarding access-site bleeding.

Conclusions:

  • Emergency PCI can be safely performed in patients with unsuccessful AMI thrombolysis.
  • Aggressive antithrombotic therapy does not significantly increase bleeding risk in these rescue PCI scenarios.
  • PCI is a safe and effective option for rescue therapy post-thrombolysis failure.

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