Journal of Nippon Medical School: Vol.69 No.2 page.172

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ArticleTitle A Clinicopathologic Study of Autopsy Cases with Myocardial Infarction Treated with Coronary Intervention (PTCA/Stenting)

AuthorList Tetsu Sakamoto¹, Koichi Tamura², Asako Aoki¹, Terumi Terada¹, Hiroyuki Yamakawa¹ and Yuichi Sugisaki²

Affiliation ¹Nippon Medical School Student, ²Division of Surgical Pathology, Nippon Medical School Hospital

Language JA

Volume 69

Issue 2

Year 2002

Page 172-179

Received August 28, 2001

Accepted October 3, 2001

Keywords coronary intervention, PTCA, stents, hemorrhagic myocardial infarction, pathology

Abstract A clinicopathologic study was made in 28 patients who died after acute myocardial infarction (AMI) treated with coronary intervention (CI: Percutaneous transluminal coronary angioplasty (PTCA) or Stenting). Nineteen patients received PTCA (12 men and 7 women, 42 to 85 years of age, mean 71.4 years), and 9 patients received stenting after PTCA (8 men and 1 woman, 49 to 86 years of age, mean 67.7 years). Hemorrhagic infarction was found in 23 cases. Compared to direct PTCA, more severe hemorrhage was found in cases treated with PTCA after intracoronary thrombolytic therapy (rescue PTCA: r-PTCA). Also, severe hemorrhage in the infarct area was found in cases treated with percutaneous cardiopulmonary support (PCPS) after AMI. Hemorrhagic infarction was found even in patients treated with CI in the early phase after AMI, and also in some patients who recovered from initial heart failure after AMI. Compared to usual ischemic infarct, healing was greatly delayed in the hemorrhagic infarct area. We conclude that special care is required in the treatment of patients who received CI, because of a high possibility of hemorrhage in the infarct area after CI and the delay in healing in the hemorrhagic infarction area.

Correspondence to Koichi Tamura, MD, Division of Surgical Pathology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
tamura@nms.ac.jp

ArticleTitle	A Clinicopathologic Study of Autopsy Cases with Myocardial Infarction Treated with Coronary Intervention (PTCA/Stenting)
AuthorList	Tetsu Sakamoto¹, Koichi Tamura², Asako Aoki¹, Terumi Terada¹, Hiroyuki Yamakawa¹ and Yuichi Sugisaki²
Affiliation	¹Nippon Medical School Student, ²Division of Surgical Pathology, Nippon Medical School Hospital
Language	JA
Volume	69
Issue	2
Year	2002
Page	172-179
Received	August 28, 2001
Accepted	October 3, 2001
Keywords	coronary intervention, PTCA, stents, hemorrhagic myocardial infarction, pathology
Abstract	A clinicopathologic study was made in 28 patients who died after acute myocardial infarction (AMI) treated with coronary intervention (CI: Percutaneous transluminal coronary angioplasty (PTCA) or Stenting). Nineteen patients received PTCA (12 men and 7 women, 42 to 85 years of age, mean 71.4 years), and 9 patients received stenting after PTCA (8 men and 1 woman, 49 to 86 years of age, mean 67.7 years). Hemorrhagic infarction was found in 23 cases. Compared to direct PTCA, more severe hemorrhage was found in cases treated with PTCA after intracoronary thrombolytic therapy (rescue PTCA: r-PTCA). Also, severe hemorrhage in the infarct area was found in cases treated with percutaneous cardiopulmonary support (PCPS) after AMI. Hemorrhagic infarction was found even in patients treated with CI in the early phase after AMI, and also in some patients who recovered from initial heart failure after AMI. Compared to usual ischemic infarct, healing was greatly delayed in the hemorrhagic infarct area. We conclude that special care is required in the treatment of patients who received CI, because of a high possibility of hemorrhage in the infarct area after CI and the delay in healing in the hemorrhagic infarction area.
Correspondence to	Koichi Tamura, MD, Division of Surgical Pathology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan tamura@nms.ac.jp