Percutaneous coronary intervention rescue PCI (PCI after failed fibrinolysis)
|
Percutaneous Coronary Intervention Guidelines Microchapters |
|
PCI Approaches: |
|---|
|
CAD Revascularization: |
|
Pre-procedural Considerations: |
|
Procedural Considerations: |
|
|
|
|
|
|
|
|
|
|
Post-Procedural Considerations: |
|
Quality and Performance Considerations: |
|
Percutaneous coronary intervention rescue PCI (PCI after failed fibrinolysis) On the Web |
|
American Roentgen Ray Society Images of Percutaneous coronary intervention rescue PCI (PCI after failed fibrinolysis) |
|
FDA on Percutaneous coronary intervention rescue PCI (PCI after failed fibrinolysis) |
|
CDC on Percutaneous coronary intervention rescue PCI (PCI after failed fibrinolysis) |
|
Percutaneous coronary intervention rescue PCI (PCI after failed fibrinolysis) in the news |
|
Blogs on Percutaneous coronary intervention rescue PCI (PCI after failed fibrinolysis) |
|
Directions to Hospitals Treating Percutaneous Coronary Intervention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (DO NOT EDIT)[1]
Immediate (or Emergency) Invasive Strategy and Rescue PCI (DO NOT EDIT)[1]
| Class I |
| "1. A strategy of coronary angiography with intent to perform PCI (or emergencyCABG) is recommended for patients who have received fibrinolytic therapy and have any of the following: " |
| "a. Cardiogenic shock in patients less than 75 years who are suitable candidates forrevascularization. (Level of Evidence: B) " |
| "b. Severe congestive heart failure and/or pulmonary edema (Killip class III). (Level of Evidence: B) " |
| "c. Hemodynamically compromising ventricular arrhythmias. (Level of Evidence: C) " |
| Class III (Harm) |
| "1. A strategy of coronary angiography with intent to perform PCI (or emergency CABG) is not recommended in patients who have received fibrinolytic therapy if further invasive management is contraindicated or the patient or designee does not wish further invasive care. (Level of Evidence: C)" |
| Class IIa |
| "1. A strategy of coronary angiography with intent to perform PCI (or emergencyCABG) is reasonable in patients 75 years of age or older who have received fibrinolytic therapy, and are in cardiogenic shock, provided that they are suitable candidates for revascularization. (Level of Evidence: B) " |
| "2. It is reasonable to perform rescue PCI for patients with 1 or more of the following'" |
| "a. Hemodynamic or electrical instability. (Level of Evidence: C) " |
| "b. Persistent ischemic symptoms. (Level of Evidence: C) " |
| "3. A strategy of coronary angiography with intent to perform rescue PCI is reasonable for patients in whom fibrinolytic therapy has failed (ST segment elevation less than 50% resolved after 90 minutes following initiation offibrinolytic therapy in the lead showing the worst initial elevation) and a moderate or large area of myocardium at risk (anteriorMI, inferior MI with right ventricular involvement or precordial ST segment depression). (Level of Evidence: B) " |
| Class IIb |
| "1. A strategy of coronary angiography with intent to perform PCI in the absence of one or more of the above Class I or IIa indications might be reasonable in moderate- and high-risk patients, but its benefits and risks are not well established. The benefits of rescue PCI are greater the earlier it is initiated after the onset of ischemic discomfort.(Level of Evidence: C) " |
References
- ↑ 1.0 1.1 Antman EM, Hand M, Armstrong PW; et al. (2008). "2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: developed in collaboration With the Canadian Cardiovascular Society endorsed by the American Academy of Family Physicians: 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction, Writing on Behalf of the 2004 Writing Committee". Circulation. 117 (2): 296–329. doi:10.1161/CIRCULATIONAHA.107.188209. PMID 18071078. Unknown parameter
|month=ignored (help)