Management of acute occlusion after percutaneous transluminal coronary angioplasty

Abstract

Acute coronary occlusion is a not infrequent complication of angioplasty. When it persists, it commonly leads to myocardial infarction, and sometimes to death. Ideally, it should be prevented by careful attention to technical predisposing factors and the routine prophylactic administration of heparin and aspirin. There are a number of strategies for managing the problem when it does occur; these frequently include re-angioplasty with standard or perfusion balloon catheters and the use of stents or atherectomy: However, if prompt reopening is not possible, then immediate coronary artery bypass grafting may be the wisest choice.