Percutaneous transluminal coronary angioplasty and its role in thrombolysis: an overview of current practice

Abstract

Listen

Translate article

Percutaneous transluminal coronary angioplasty (PTCA) is now widely applied to sufferers of ischaemic heart disease who several years ago would have been referred for surgery, with success rates increasing as operator experience improves. Incurred hospital stay can be reduced from 10 days for surgery to 2 to 3 days for PTCA. Nursing care of these patients demands high standards of psychological care and potentially care of the critically ill. Nurses need to ensure their learning and research keeps up with the ever changing aspects of ischaemic heart disease. Since the GISSI study (Rovelli et al, 1986) was published thrombolytic therapy is now standard treatment for those suffering acute myocardial infarction (MI) within 6 hours of pain onset. New studies by ISIS-2 (1988) may even radically change the perceptions of time limits in these patients. After thrombolysis, a high grade lesion is often present to cause continuing pain or threat of re-closure. PTCA in these patients can relieve the patient equally as well at 10 days post-infarct as at immediate intervention, if the patient is clinically stable. Good post-therapy counselling services are essential in the long-term treatment of these sufferers to help reduce risk factors and therefore further development of myocardial disease.