Reperfusion Therapy in Acute Myocardial Infarction

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Abstract
Coronary arterial occlusion due to thrombosis is the cause of most cases of myocardial infarction accompanied by ST-segment elevation. Rapid restoration of blood flow to jeopardized myocardium limits necrosis and reduces mortality. This can be accomplished medically, with a thrombolytic agent, or mechanically, with so-called primary balloon angioplasty or stenting (see figure). Each method has its advantages and limitations.Thrombolytic therapy is widely available and effective, but its use is sometimes associated with bleeding complications. In 10 to 15 percent of patients who receive a thrombolytic agent, clot lysis is not achieved. Only half the patients in whom antegrade coronary . . .

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