Repeat thrombolysis for early coronary arterial reocclusion

Background: After successful coronary artery thrombolysis, thrombogenic substrate persists, increasing the risk of both reocclusion and reinfarction. Although many patients experiencing threatened reinfarction undergo emergent coronary angiography and mechanical revascularization, it is conceivable that repeat thrombolysis represents an important treatment alternative. Methods: A review of English language literature identified using an electronic database search. Results: Repeat thrombolysis, although not investigated in a randomized fashion to date, has been shown in selected patient groups to provide rapid benefit; in approximately 50% of patients reinfarction may be prevented, and among initial responders a majority experience sustained benefit. Conclusions: Patients with coronary artery reocclusion represent a high-risk patient group. Repeat thrombolysis, primarily with recombinant tissue plasminogen activator represents a treatment alternative that deserves further investigation.

Duke Scholars

Author Richard Clinton Becker Medicine, Cardiology