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Evolution of Invasive Therapies in Acute Myocardial Infarction: A Descriptive Review


Authors : Tejesshwin S.; Subasri S.; Neeharika L.; Santhanalakshmi V.; Dr. D. P. Sivasakti Balan; R. J. Thayumanaswamy

Volume/Issue : Volume 11 - 2026, Issue 8 - August


Google Scholar : https://tinyurl.com/yr6fux8v

Scribd : https://tinyurl.com/ybtxbmkd

DOI : https://doi.org/10.38124/ijisrt/26aug255

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Abstract : Acute myocardial infarction (AMI) is a major cardiovascular emergency in which rapid restoration of coronary blood flow is essential to minimize myocardial damage and improve patient outcomes. The management of AMI has undergone substantial evolution, progressing from conventional surgical revascularization to less invasive percutaneous coronary interventions (PCI). Coronary artery bypass grafting (CABG), although an established and effective revascularization procedure, involves open-chest surgery and is associated with greater procedural invasiveness, longer recovery, and increased perioperative burden compared with contemporary catheter-based interventions. The introduction of balloon angioplasty represented an important advancement by allowing coronary revascularization without open surgery; however, balloon angioplasty alone was limited by complications such as elastic recoil, vessel dissection, and restenosis, which reduced its longterm effectiveness. The development of intracoronary stents subsequently transformed PCI by providing mechanical support to the treated vessel, reducing acute vessel closure and improving procedural success and long-term vessel patency. In the contemporary management of AMI, particularly ST-segment elevation myocardial infarction (STEMI), primary PCI with stent implantation is widely preferred when it can be performed promptly by an experienced team. Its minimally invasive nature, high procedural success, and ability to rapidly restore coronary perfusion have established stenting as a major advancement in invasive AMI treatment. This descriptive review traces the evolution from CABG and balloon angioplasty to modern stentbased PCI and discusses the clinical advantages, limitations, and continuing developments in invasive revascularization strategies for AMI.

Keywords : Acute Myocardial Infarction, Coronary Artery Bypass Grafting, Balloon Angioplasty, Percutaneous Coronary Intervention, Coronary Stent, Primary PCI, Revascularization.

References :

  1. Fischman DL, Leon MB, Baim DS, et al. A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. N Engl J Med. 1994;331(8):496-501. doi:10.1056/NEJM199408253310802.
  2. Morice MC, Serruys PW, Sousa JE, et al. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med. 2002;346(23):1773-1780. doi:10.1056/NEJMoa012843.
  3. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet. 2003;361(9351):13-20. doi:10.1016/S0140-6736(03)12113-7.
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  6. Fischman DL, Leon MB, Baim DS, Schatz RA, Savage MP, Penn I, et al. A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. N Engl J Med. 1994;331(8):496-501. doi:10.1056/NEJM199408253310802.
  7. Morice MC, Serruys PW, Sousa JE, Fajadet J, Ban Hayashi E, Perin M, et al. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med. 2002;346(23):1773-1780. doi:10.1056/NEJMoa012843.
  8. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet. 2003;361(9351):13-20. doi:10.1016/S0140-6736(03)12113-7.
  9. Stone GW, Ellis SG, Cox DA, Hermiller J, O'Shaughnessy C, Mann JT, et al. A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease. N Engl J Med. 2004;350(3):221-231. doi:10.1056/NEJMoa032441.
  10. Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, Mack MJ, et al. Percutaneous coronary intervention

Acute myocardial infarction (AMI) is a major cardiovascular emergency in which rapid restoration of coronary blood flow is essential to minimize myocardial damage and improve patient outcomes. The management of AMI has undergone substantial evolution, progressing from conventional surgical revascularization to less invasive percutaneous coronary interventions (PCI). Coronary artery bypass grafting (CABG), although an established and effective revascularization procedure, involves open-chest surgery and is associated with greater procedural invasiveness, longer recovery, and increased perioperative burden compared with contemporary catheter-based interventions. The introduction of balloon angioplasty represented an important advancement by allowing coronary revascularization without open surgery; however, balloon angioplasty alone was limited by complications such as elastic recoil, vessel dissection, and restenosis, which reduced its longterm effectiveness. The development of intracoronary stents subsequently transformed PCI by providing mechanical support to the treated vessel, reducing acute vessel closure and improving procedural success and long-term vessel patency. In the contemporary management of AMI, particularly ST-segment elevation myocardial infarction (STEMI), primary PCI with stent implantation is widely preferred when it can be performed promptly by an experienced team. Its minimally invasive nature, high procedural success, and ability to rapidly restore coronary perfusion have established stenting as a major advancement in invasive AMI treatment. This descriptive review traces the evolution from CABG and balloon angioplasty to modern stentbased PCI and discusses the clinical advantages, limitations, and continuing developments in invasive revascularization strategies for AMI.

Keywords : Acute Myocardial Infarction, Coronary Artery Bypass Grafting, Balloon Angioplasty, Percutaneous Coronary Intervention, Coronary Stent, Primary PCI, Revascularization.

Paper Submission Last Date
31 - August - 2026

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