Review: Rescue percutaneous coronary intervention but not repeated fibrinolysis is effective for failed fibrinolysis in STEMI

摘要

It has been nearly impossible to conduct RCTs of rescue PCI in thenUnited States because of the strong bias toward it. Guidelines considerednrescue PCI to be a class 1 indication even before trials indicated itsnbenefit (1). Although there are important differences among the trialsnincluded in the meta-analysis by Wijeysundera and colleagues, the datanare sufficiently compelling to support routine performance of rescuenPCI and its classification as a class 1 indication in STEMI guidelines.nRescue PCI increases bleeding complications, but a radial arterynapproach has been shown to reduce bleeding rates and may be particularlynbeneficial in this setting (2).