New Strategies For Reperfusion Therapy

A new trial has begun in order to ascertain once and for all whether the best strategy for patients who cannot receive P-PCI is early fibrinolysis, together with mandated angiography. This is the STREAM trial whose principal investigators are Profs Frans van der Werf, Paul Armstrong and Tony Gershlick. Acute occlusion of a major coronary artery due to disruption of an atheromatous plaque and the formation of occlusive thrombus has major clinical implications.