Intracoronary administration of the combined fibrinolytic therapy a in patient with acute myocardial infarction and end-stage coronary heart disease - a case report]

Classical thrombolytic treatment in acute myocardial infarction is able to reach reperfusion in 60-80% of patients, however in 5-10% of cases reoclusion occurs. Primary percutaneous coronary intervention (PCI) offers the potential for a higher rate of reperfusion and a lower rate of bleeding events. Recently, advances in platelet inhibition and PCI procedures have led to the combination of all the approaches. Facilitated PCI or the use of elective PCI after pharmacological reperfusion therapy can combine the best aspects of thrombolysis and mechanical revascularization in acute myocardial infarction. However, in some cases PCI cannot be performed. This paper describes a patient with acute myocardial infarction successfully treated with intracoronary infusion of alteplase and GP IIb/IIIa inhibitor.