Utilization of PCI After Fibrinolysis

Abstract

The facilities and expertise required for primary percutaneous coronary intervention (PPCI) of the infarct-related artery (IRA) in patients with ST-elevation myocardial infarction (STEMI) are only available at a limited number of hospitals. Fibrinolytic therapy, on the other hand, is more widely deliverable. This creates two distinct reperfusion choices: PPCI or a pharmacoinvasive strategy. The first option relies on immediate transfer to the closest PPCI-capable centre even if it means bypassing a closer non-PPCI centre. The second option is the “drip and ship” strategy. It involves delivery of fibrinolytic therapy by a non-PPCI facility with rapid transfer to a PPCI-capable centre.