Intracoronary Lysis

Abstract

Intracoronary infusion of streptokinase is associated with acute recanaliza tion rates of 60 to 90%. Mortality data in the published trials have been conflict ing. In an analysis of ejection fraction changes in 125 registry patients who had contrast angiography prior to streptokinase infusion and a repeat study prior to hospital discharge, improvement of ejection fraction was found to correlate with incomplete coronary obstruction prior to angiography, the presence of col laterals to the infarct area and recanalization of complete obstruction. In assess ing the risk/benefit ratio of intracoronary streptokinase infusion, the risks of acute angiography, reperfusion arrhythmias in patients with severe depression of left ventricular function, reocclusion, bleeding and secondary interventions such as angioplasty or bypass surgery have to be considered.