[Regression of residual coronary stenosis after recanalization by fibrinolysis in myocardial infarction. Quantitative analysis of coronary angiography immediately after obstruction removal, at a 15-day and 3-month follow-up].
There seems to be a high risk of reobstruction after local fibrinolytic therapy in myocardial infarction because the severity of the residual stenosis. However, it is quite common to observe a significant improvement of these stenoses at follow-up coronary angiography. Also, one may demonstrate a patent coronary artery after initial failure of the recanalisation procedure. The aim of this research was to study objectively the outcome of the residual coronary stenosis after intracoronary fibrinolytic therapy during myocardial infarction. The degree of stenosis expressed as a percentage reduction of the average diameter of the vessel measured in two perpendicular incidences was assessed immediately after initial fibrinolytic therapy, and at 15 days and 3 months' follow-up. The study group of 31 patients was divided into two subgroups: group I (16 patients) with successful revascularisation and a patent vessel at the first control; and group II (15 patients): unsuccessful revascularisation or with reobstruction at the first control angiography (2 cases). The coronary angiographies were interpreted by an observer who had no knowledge of the patients or of the order of the investigations. In group I, the degree of stenosis decreased from 74 +/- 18 p. 100 to 64 +/- 16 p. 100 (p less than 0.05) at the first control, and then to 47 +/- 24 p. 100 (p less than 0.001) at the second control (less than 50 p. 100 in 7 cases).(ABSTRACT TRUNCATED AT 250 WORDS)