Coronary reocclusion after selective administration of streptokinase. 1983

H K Gold, and R C Leinbach, and I F Palacios, and T Yasuda, and P C Block, and M J Buckley, and C W Akins, and W M Daggett, and W G Austen

Intracoronary streptokinase was given to 40 patients with acute transmural myocardial infarction. In 34 of the patients (85%), it resulted in reflow or improved flow. Six patients showed no reflow and six reocclusion within 2 hours. No consistent explanation was found for this resistance to therapy. Five other patients developed reocclusion after 6 days to 11 months, when heparin or warfarin anticoagulation had been stopped. Percutaneous angioplasty at the time of streptokinase infusion was performed in seven, with six successes. Bypass surgery was performed after successful streptokinase administration in eight. Follow-up revealed recurrent ischemia in patients successfully treated with streptokinase alone, but not in patients with successful angioplasty or bypass surgery. Long-term coronary patency after thrombolysis may require careful anticoagulation or a procedure that modifies or bypasses the residual stenosis.

UI MeSH Term Description Entries
D009203 Myocardial Infarction NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION). Cardiovascular Stroke,Heart Attack,Myocardial Infarct,Cardiovascular Strokes,Heart Attacks,Infarct, Myocardial,Infarction, Myocardial,Infarctions, Myocardial,Infarcts, Myocardial,Myocardial Infarctions,Myocardial Infarcts,Stroke, Cardiovascular,Strokes, Cardiovascular
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D003327 Coronary Disease An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels. Coronary Heart Disease,Coronary Diseases,Coronary Heart Diseases,Disease, Coronary,Disease, Coronary Heart,Diseases, Coronary,Diseases, Coronary Heart,Heart Disease, Coronary,Heart Diseases, Coronary
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000800 Angioplasty, Balloon Use of a balloon catheter for dilation of an occluded artery. It is used in treatment of arterial occlusive diseases, including renal artery stenosis and arterial occlusions in the leg. For the specific technique of BALLOON DILATION in coronary arteries, ANGIOPLASTY, BALLOON, CORONARY is available. Balloon Angioplasty,Dilation, Transluminal Arterial,Arterial Dilation, Transluminal,Arterial Dilations, Transluminal,Dilations, Transluminal Arterial,Transluminal Arterial Dilation,Transluminal Arterial Dilations
D001026 Coronary Artery Bypass Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. Aortocoronary Bypass,Bypass, Coronary Artery,Bypass Surgery, Coronary Artery,Coronary Artery Bypass Grafting,Coronary Artery Bypass Surgery,Aortocoronary Bypasses,Artery Bypass, Coronary,Artery Bypasses, Coronary,Bypass, Aortocoronary,Bypasses, Aortocoronary,Bypasses, Coronary Artery,Coronary Artery Bypasses
D013300 Streptokinase Streptococcal fibrinolysin . An enzyme produced by hemolytic streptococci. It hydrolyzes amide linkages and serves as an activator of plasminogen. It is used in thrombolytic therapy and is used also in mixtures with streptodornase (STREPTODORNASE AND STREPTOKINASE). EC 3.4.-. Avelizin,Awelysin,Celiase,Distreptase,Kabikinase,Kabivitrum,Streptase,Streptodecase

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