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  recanalization
In acute myocardial infarction thrombolysis has been shown to achieve an early recanalization of an occluded vessel in a high percentage of patients and to reduce mortality significantly.
      
In contrast to heparin alone, thrombolysis has the advantage of high recanalization rates.
      
With clinically used dosage regimens of streptokinase complete and partial recanalization rates are in the range of 60-70% of primary occluded veins.
      
Early recanalization saves tissue at risk of irreversible infarction and leads to significantly smaller infarcts and a significantly better clinical outcome.
      
Patients with more proximal vessel occlusions have a larger tissue at risk and a lower recanalization rate which is associated with a worse clinical outcome.
      
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  recanalized
The vessel was successfully recanalized by implantation of two stents.
      
Bacterial endocarditis of a recanalized Waterston-Cooley anastomosis -
      
Because of further progression of symptoms, we recanalized the left ICA by deployment of a stent and subsequent angioplasty under the protection of abciximab and heparin.
      
In our second patient, myocardial infarction developed 5 days after vinblastine treatment; early angiography showed thrombotic occlusion of the proximal right coronary artery, which was recanalized using the diagnostic Sones catheter.
      
In 41 patients at least one artery was recanalized (93%) by rt-PA, and in almost half of these patients (48%) no residual stenosis were detected after the lytic treatment.
      
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  coronary recanalization
Certain outcomes of PCI may be specifically related to the technology utilized for coronary recanalization.
      
Coronary recanalization by elective angioplasty prevents ventricular dilation after anterior myocardial infarction.
      
The present results show that coronary recanalization variably reduces the infarct-associated rise in serum C-reactive protein.
      
  其他


Eight patients with AMI were treated by thrombolysis with bedside intracoronary urokinase. All patients were stable during thrombolytic therapy. The time of bedside coronary angiography was 25 ± 4. 4 minutes. Reperfusion was achieved in 5 patients after intracoronary urokinase and the time of reperfusion was 21. 7±9. 2 minutes, and the amount of urokinase used was 191 ± 113 thousand units. No reperfusion was observed in 3 patients after 2-hr thrombolytic therapy.It is concluded that (1) bedside intracoronary...

Eight patients with AMI were treated by thrombolysis with bedside intracoronary urokinase. All patients were stable during thrombolytic therapy. The time of bedside coronary angiography was 25 ± 4. 4 minutes. Reperfusion was achieved in 5 patients after intracoronary urokinase and the time of reperfusion was 21. 7±9. 2 minutes, and the amount of urokinase used was 191 ± 113 thousand units. No reperfusion was observed in 3 patients after 2-hr thrombolytic therapy.It is concluded that (1) bedside intracoronary thrombolysis is time-saving as comparing with thrombolytic therapy in the catheterization room; (2) the effective reperfusion time of bedside intracoronary thrombolysis is much shorter than that of intravenous thrombolysis,and the former is more effective in recanalization of theinfarctrelated coronary artery. So it is a useful method for patients with AMI.

本文报道8例急心肌梗塞患者的床旁冠状动脉(冠脉)内尿激酶(UK)溶栓治疗(PTCR)。8例患者PTCR顺利,其间病情稳定。冠脉造影时间为25±4.4min。5例患者PTCR后21.7±9.2min梗塞冠脉再通再通时UK量19.1±11.3万U。3例患者持续PTCR达2h,梗塞冠脉未能再通。结果表明,PTCR直接应用于床旁避免了传统PTCR需专用导管室和多科人员参与而难以应用于急诊的不足;床旁PTCR的有效再通时间短于静脉溶栓,更能有效地恢复冠脉血流和缩小梗塞范围。作者认为床旁PTCR是一种适合急诊溶栓的可行方法。

To assess the effects of thrombolysis on late potentials after acute myocardial infarction(AMI),180 patients(154 males, 26 females, aged 63±10 years)underwent late potential studies at 5.9±3.4 days, with the use of a 25 to 250 Hz band-pass filter. The presence of late potential was ascertained when≥2 of the 3 defined criteria were present. The thrombolytic group consisted of 52 patients while the nonthrombolytic group included 128. There was a significant difference in the incidence of late potentials between...

To assess the effects of thrombolysis on late potentials after acute myocardial infarction(AMI),180 patients(154 males, 26 females, aged 63±10 years)underwent late potential studies at 5.9±3.4 days, with the use of a 25 to 250 Hz band-pass filter. The presence of late potential was ascertained when≥2 of the 3 defined criteria were present. The thrombolytic group consisted of 52 patients while the nonthrombolytic group included 128. There was a significant difference in the incidence of late potentials between the thrombolytic and nonthrombolytic group (17. 3% vs. 39.1%,respectively; p<0. 05). The patients who received thrombolytic therapy were divided into two groups according to the noninvasive indication of patency , 31 patients with patency and 21 patients without patency. There was a significant difference in the incidence of late potentials between patency and without patency group (6.5% vs. 33.3%, respectively; p<0.05). 18 patients received coronary angiography were divided into two groups, 11 patient with patency (TIMI grades 2 and 3) and 7 patients without patency (TIMI grades 0 and 1). There was also a significant difference in the incidence of late potentials between patency group and without patency group. It is indicated that the incidence of late potentials after AMI is reduced by thrombolysis. The effects of thrombolysis on late potentials were explained by reperfusion.

本文评价溶栓治疗对急性心肌梗塞患者晚电位的影响。180例患者发病后5.9±3.4天描记晚电位。按溶栓与否分为:溶栓组52例;非溶栓组128例。晚电位阳性发生率分别为17.3%和39.1%(P<0.05);溶栓患者按冠状动脉再通间接指征分为再通组31例,未再通组21例,晚电位阳性发生率分别为6.5%和33.3%(P<0.05);冠状动脉造影18例,按心肌梗塞溶栓治疗标准分为再通组11例,未再通组7例,晚电位阳性发生率分别为9.1%和57.1%(P<0.05),均有显著性差异。提示溶栓治疗可降低心肌梗塞晚电位阳性发生率,其作用机制与再灌注有关。

Angiographic morphology of coronary lesions Was analysed at early stage of acute myocardial infarction in 45 patients, 37 of whom underwent thrombolysis.The results showed:(l) TypeⅡlesions,which often represent plaque rupture usually with thrombosis superimposed,were observed in 70% of 30 infarction-related lesions located at the reperfused arteries after thrombolysis compared with only 22. 6% of 31 noninfarction -related lesions with narrowing of 50% to less than 100% (p<0. 005). (2)TypeⅡ lesions were more...

Angiographic morphology of coronary lesions Was analysed at early stage of acute myocardial infarction in 45 patients, 37 of whom underwent thrombolysis.The results showed:(l) TypeⅡlesions,which often represent plaque rupture usually with thrombosis superimposed,were observed in 70% of 30 infarction-related lesions located at the reperfused arteries after thrombolysis compared with only 22. 6% of 31 noninfarction -related lesions with narrowing of 50% to less than 100% (p<0. 005). (2)TypeⅡ lesions were more often found in eccentric lesions than in concentric ones (71%vs.20%,p<0.005). It is concluded that plaque rupture with thrombosis superimposed is probably very important in the development of most of the Qwave myocardial infarction , and that eccentric plaques are prone to rupture.

分析了45例急性心肌梗塞患者(37例进行了溶栓治疗)急性期冠状动脉造影所示的病变形态学特点。结果为:①30例溶栓治疗再通的梗塞相关病变Ⅱ型斑块(常代表斑块破裂伴有或不伴有血栓的形成)的发生率为70%;非梗塞相关病变(狭窄≥50%并<100%)Ⅱ型斑块的发生率仅22.6%。②偏心斑块的Ⅱ型斑块发生率明显高于向心斑块者(71%对20%)。结果提示,斑块破裂及随之发生的血栓形成是急性心肌梗塞的重要发病基础;偏心斑块易于破裂。

 
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