Background:Several studies have shown PTCA performed early afterthrombolysis to be unnecessary or even harmful.However,PTCA in these trialswas generally performed 1-3 days aider AMI,when the patient may be unsuitedfor PTCA,and the incidence of major complications was high.We observed theinitial results of dalayed PTCA(7-30 days) in patients with residual stenosis andevidence of iscbemia.Methods and Results:28 patients were eligible for inclusion:1)They hadreceived intravenous thrombolytic therapy within 12 hours of symtom onset ofAMI.2)They had postinfarction angina,or≥1mm fiat or downsloping STsegment depressions or T wave inversions,or the response of segmental wallmotion abnormalities to nitrates or dobutamine.3)They had an infarct-arterystenosis of≥50% diameter stenosis.Mean age was 56±10 yeats.Proceduralsuccess was obtained in 26 patients(92.8%),guidewire could not cross one totalocclusion lesion and balloon could not get through another.Intracoronarystenting was performed in 15 of 26 patients(57.7%).Diameter stenosis wasreduced from 75±12% to 22±10%.In-hospital or parioperativecomplications were as follows:digest tract bleeding,one(3.8%);subacuteclosure,one(3.8%).There was no significant increase in ejection fraction 4-weeks later.There was no reinfarction during the 12 months of follow-up.Cnnclusion:In this selected patient population,late elective PTCA results in alow incidence of in-hospital and parioparative complications.Clinical success,defined by absence of symptoms,appears to be sustained at 1 year.
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