Sounding Boards. Let's not let the genie escape from the bottle--again.

A BOLD and exciting new technique to protect ischemic myocardium has recently been developed. In several pilot studies carried out in patients with acute myocardial infarction, it has been shown that acutely occluded coronary arteries can be recanalized by the intracoronary injection of streptokinase or a fibrinolytic agent.1 2 3 4 5 6 If optimum care is to be provided to the million or so patients who have acute myocardial infarction each year, this technique deserves more carefully designed evaluation than that given a similarly bold and exciting technique developed a little more than a decade ago: coronary-artery bypass grafting (CABG). CABG was quickly recognized . . .

[1]  H. Gold,et al.  Regional streptokinase in myocardial infarction. , 1981, Circulation.

[2]  K. Kuck,et al.  Non surgical coronary artery recanalization in acute transmural myocardial infarction. , 1981, Circulation.

[3]  D. Berman,et al.  Intracoronary thrombolysis in evolving myocardial infarction. , 1981, American heart journal.

[4]  R. Kloner,et al.  The no reflow phenomenon: a time-limiting factor for reperfusion after coronary occlusion? , 1980, The American journal of cardiology.

[5]  E. Braunwald,et al.  Review: Observations on experimental myocardial ischaemia , 1980 .

[6]  E. Antman,et al.  Salvage of acutely ischemic myocardium by emergency coronary artery bypass grafting , 1980, Clinical cardiology.

[7]  M. Zelen A new design for randomized clinical trials. , 1979, The New England journal of medicine.

[8]  K. Karsch,et al.  Initial experience with transluminal recanalization of the recently occluded infarct‐related coronary artery in acute myocardial infarction — Comparison with conventionally treated patients , 1979, Clinical cardiology.

[9]  E. Braunwald,et al.  Myocardial ischemia (first of three parts). , 1977, The New England journal of medicine.

[10]  Chazov Ei,et al.  Intracoronary administration of fibrinolysin in acute myocardial infarct , 1976 .

[11]  J. Ross,et al.  Deleterious effects due to hemorrhage after myocardial reperfusion. , 1974, The American journal of cardiology.

[12]  E. Braunwald Acute Myocardial Infarction: A Status Report , 1971 .

[13]  R. Boucek,et al.  Segmental perfusion of the coronary arteries with fibrinolysin in man following a myocardial infarction. , 1960, The American journal of cardiology.