to Tona - ben

[ArchivalUser]

Tona, can u pls explain why stenting would be done if the pt is refractory to thombolytic therapy , since as u said before PTCA is not really usefull after 90 min of an acute MI b/c of dead muscle
thx

[ArchivalUser]

there is an issue called " failed thrombolysis" ( infact it can be as high as 50% in case of non-specific Thrombolyics like STK, BEYOND THE FIRST HOUR of onset).... where clearly from symptoms & Non-resolving or NEWLY evolving ECG pattern it is evident that the clot has NOT been fully (or partially) dissolved..... in such cases it becomes imperative to use PTCA ( MECHANICAL revascularization) , under direct vision, to dilate(ballooning) & stent (bare metal/DES) THE CULPRIT vessel.... this is more aptly called nowadays as RESCUE PTCA.

of course , following the stenting he has to be put under Dual Anti-platelets for atleast a year ( and sometimes life long).

BTW, primary PTCA is nowadays done in plenty of places ... I an sure in the US it should be >20% tertiary hospitals( In India its more than that in tertiary hospitals).