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Abstract
PTCA was performed in 28 patients with acute MI immediately after intracoronary streptokinase
administration. Indications were failure to obtain reflow in 16 patients and high-grade
residual stenosis in 12. PTCA was successful in 11 of 16 cases of streptokinase failure,
increasing the overall reflow rate from 66% to 77%. PTCA reduced residual coronary
stenosis by more than 20% in 9 of 12 cases in which streptokinase infusion was successful,
with 1 acute reocclusion. The frequency of recurrent ischemic events in hospital was
76% in patients with a stenosis of 90% or greater after streptokinase infusion (no
PTCA), 14% when residual stenosis was less than 90%, and 6% after successful PTCA.
Late restenosis or reocclusion was documented in 5 of 11 PTCA cases (45%). Immediate
PTCA after streptokinase administration produces increased clinical stability in hospital,
but late restenosis is frequent.
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© 1984 Published by Elsevier Inc.
