Acute Myocardial Infarction Treatment Options: Minimally Invasive Interventional Approaches

Acute myocardial infarction (AMI), commonly known as a heart attack, requires prompt medical intervention to restore blood flow and minimize damage to the heart muscle. In recent years, interventional cardiology has significantly advanced, offering minimally invasive techniques that effectively treat AMI. These procedures are typically performed in a cardiac catheterization lab and aim to quickly reopen blocked arteries.

Coronary Balloon Angioplasty: A Foundational Technique

Coronary balloon angioplasty remains a cornerstone in the treatment of severe arterial blockages. When a significant narrowing is identified, a guidewire is carefully maneuvered through the obstruction. In such cases, deploying a stent may be challenging, so a balloon is used first to dilate the artery. This pre-dilatation helps prepare the vessel for subsequent stent placement, ensuring better apposition and expansion of the stent.

Drug-Eluting Stent Implantation: Restoring Blood Flow

When a coronary artery exhibits a narrowing of more than 75%, implantation of a drug-eluting stent (DES) becomes necessary. These stents are coated with medication that helps prevent re-narrowing of the artery. The stent is precisely placed at the site of the blockage, expanding the vessel and restoring coronary blood flow to optimal levels—ideally reaching TIMI grade 3 flow, which signifies normal blood movement through the artery.

Thrombus Aspiration: Removing Clots Effectively

In cases where a large clot is present within the coronary artery, thrombus aspiration may be employed. This technique utilizes a catheter-based system that applies negative pressure to suction out the clot. By reducing the overall thrombus burden, this method helps improve blood flow and reduces the risk of distal embolization during the procedure.

Intracoronary Thrombolytic Therapy via Microcatheter

Targeted Clot Dissolution

For patients with extensive clot formation, microcatheter-directed thrombolysis can be an effective option. This involves the use of a specialized infusion pump that delivers clot-dissolving medication directly into the coronary artery. This localized approach enhances reperfusion, helping to reestablish blood flow in the affected area and improve clinical outcomes.

Distal Protection Devices: Preventing Complications

To enhance procedural safety, distal protection devices are often used during interventional procedures. These devices help prevent thromboembolic events by capturing dislodged debris or clot fragments before they can travel downstream and block smaller vessels. By reducing the risk of slow or no-reflow phenomena, these tools contribute to better immediate results and improved long-term prognosis for patients with acute myocardial infarction.