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[Intracoronary thrombolysis]
Insights
Intracoronary Urokinase effectively treated acute myocardial infarction, achieving vessel recanalization in 88% of patients. Successful thrombolysis improved cardiac function, demonstrating Urokinase
Area of Science:
- Cardiology
- Interventional Cardiology
- Thrombolytic Therapy
Context:
- Acute myocardial infarction (AMI) remains a leading cause of mortality.
- Prompt restoration of coronary blood flow is critical for myocardial salvage.
- Intracoronary thrombolysis offers a potential therapeutic strategy for AMI.
Purpose:
- To evaluate the efficacy and safety of intracoronary Urokinase administration in patients with acute myocardial infarction.
- To assess the impact of different Urokinase infusion rates on recanalization success.
- To determine the effect of successful thrombolysis on left ventricular function.
Summary:
- Intracoronary Urokinase was administered to 42 patients with acute myocardial infarction.
- Recanalization of occluded coronary vessels was achieved in 36 patients (88%).
- Successful thrombolysis correlated with improved left ventricular ejection fraction in patients with pre-existing depressed function.
Impact:
- Intracoronary Urokinase demonstrates significant efficacy in restoring coronary patency during acute myocardial infarction.
- The treatment leads to functional cardiac improvement, particularly in patients with compromised left ventricular function.
- This study supports the use of intracoronary Urokinase as a viable thrombolytic option in managing acute myocardial infarction.
Abstract:
Intracoronary Urokinase administration was attempted in 42 patients with acute myocardial infarction. One patient died before Urokinase infusion could be started, two patients during treatment. 34 patients (83%) had total occlusion of a coronary vessel, 7 patients (17%) had a subtotal occlusion. Urokinase was administered at a rate of 10.000 IU/min in 11 consecutive patients (Group I), 6000 IU/min in 11 patients (Group II), 4000 IU/min in 11 patients (Group III), 2000 IU/min in 8 patients (Group IV). Recanalization of the occluded vessel or amelioration of the subocclusion was obtained in 36 patients (88%). 35 patients were controlled 12 days after the procedure, with coronary-angiography and left ventriculography. Patency persisted in 31 patients and successful thrombolysis was associated with significant improvement of left ventricular ejection fraction in those patients with depressed ventricular function before Urokinase treatment.