[Intracoronary treatments in emergency situations]

Mechanical and medicinal therapies are widely used in coronary disease patients for emergency or semi-emergency situations. Vasodilator drugs injected into arteries that are occluded or narrowed-drugs injected into arteries that are occluded or narrowed by spasm rapidly relieve that spasm; injecting these drugs prior to angioplasty renders the myocardium more tolerant to the ischaemia created by the dilated balloon. In unstable angina coronary angioplasty has a 90 p. 100 primary success rate with immediate complications that are slightly more frequent than in stable angina; compared to historical series with medicinal treatment, angioplasty reduces the risk of myocardial infarction and/or secondary death. In evolving myocardial infarcts the respective values of intracoronary thrombolysis and angioplasty are still under discussion, although the results of recent studies tend to favour intravenous thrombolysis and secondary, elective angioplasty.