Mechanical reperfusion in patients with acute myocardial infarction presenting more than 12 hours from symptom onset: a randomized controlled trial.

Context: No specifically designed studies have addressed the role of primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction (STEMI) presenting more than 12 hours after symptom onset. Current guidelines do not recommend reperfusion treatment in these patients.

Objective: To assess whether an immediate invasive treatment strategy is associated with a reduction of infarct size in patients with acute STEMI, presenting between 12 and 48 hours after symptom onset, vs a conventional conservative strategy.

Early administration of reteplase plus abciximab vs abciximab alone in patients with acute myocardial infarction referred for percutaneous coronary intervention: a randomized controlled trial.

Context: The optimal pharmacological strategy for bridging the delay between admission and performance of percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (MI) is not known.

Objective: To assess whether early administration of reteplase plus abciximab produces better results compared with abciximab alone in patients with acute MI referred for PCI.

Design, Setting, And Patients: Open-label, randomized controlled study conducted from May 3, 2001, through June 2, 2003, of 253 patients who were admitted to 13 community hospitals without catheterization facilities (n = 186) and to 5 hospitals with catheterization facilities (n = 67), with the diagnosis of an ST-segment elevation acute MI within 12 hours from onset of symptoms.

[Experiences in the diagnosis and therapy of so-called thrombus in transit].

With the increasing use of cross-sectional echocardiography in patients with overt or suspected pulmonary thromboembolism in the emergency rooms, more and more right atrial thrombi are detected. These are so-called "transitthrombi" from the venous system on their way to the pulmonary arteries and they are a severe presentation of thromboembolic disease. They appear as an imminent pulmonary embolism and usually coexists with an already massive embolism.

[Transesophageal ultrasound for staging lung tumors].

Purpose: The usefulness of transesophageal sonography in staging lung cancer was examined.

Method: Transoesophageal sonography was performed in 15 patients as a staging examination using either biplane or multiplane technique. The results were compared with other radiological techniques such as computed tomography and, if performed, with the findings in the operation.

[Cerebral air embolism after central venous catheter].

Introduction of air into the arterial circulation can cause cerebral air embolism, leading to severe neurological deficits. A case is reported on a patient suffering from fatal cerebral air embolism after a subclavian vein catheter had been inserted. The risks associated with inserting and removing central venous catheters are described.

[Anomalous origin of the left coronary artery from the right sinus of Valsalva with acute symptoms].

The case of a 52-year-old man with an anomalous origin of the left coronary artery from the right sinus of valsalva coursing between the aorta and pulmonary trunk is reported with an acute myocardial ischemia. He had an additional high-grade main-stem stenosis in the course behind the pulmonary artery. The anatomical variants, clinical significance, and cause of ischemia are discussed.