ABSTRACT
Acute coronary syndromes represent an increasing proportion of the workload of the interventionist. For patients who present with unstable angina and non-Q wave MI, PTCA and stenting offers a rapid and efficient means of terminating ischaemia and facilitating the patient’s discharge on less medication. In some places that have more favourable logistics than the average centre in the UK, particularly the United States, patients presenting with acute myocardial infarction are frequently treated by primary angioplasty rather than thrombolysis. The recent data suggest that such patients benefit from stenting rather than balloon alone. Furthermore, the desire to limit myocardial damage around the time of acute MI has led, entirely appropriately, to a rapid increase in the number of patients referred for revascularization who have not responded to thrombolysis or who have clearly reinfarcted following apparently successful chemical recanalization of the infarct-related vessel.
