Myocardial infarction is a condition in which a coronary artery is suddenly blocked due to a cracked or ruptured atherosclerotic plaque, forming a blood clot that blocks the lumen of the vessel.

This is an emergency situation, requiring coronary revascularization as soon as possible to save the heart muscle and avoid dangerous complications such as heart failure, arrhythmia, and even death.

Percutaneous coronary intervention is an emergency reperfusion strategy for acute myocardial infarction that combines modern technology to maximize treatment effectiveness.

According to People's Doctor Nguyen Thi Bach Yen, Head of Cardiology Department, Tam Anh General Hospital Hanoi, patients with myocardial infarction need to be taken to a medical facility that can reperfuse coronary arteries as soon as possible to increase the chance of survival.

Reperfusion methods include thrombolysis (for patients who present early and have no contraindications, especially in medical facilities that do not have the ability to perform coronary artery intervention), coronary artery bypass grafting (in cases of severe three-vessel coronary artery damage), and percutaneous coronary intervention.

Percutaneous coronary intervention is the most effective emergency reperfusion method for acute myocardial infarction, providing many chances of survival for patients.

In particular, the application of many modern technologies, such as coronary optical coherence tomography (OCT) and intravascular ultrasound (IVUS), helps increase treatment effectiveness and speed up recovery time for patients.

As in the case of Mr. B., 53 years old, who was hospitalized with an acute myocardial infarction, atherosclerotic plaque caused 95% narrowing of the anterior interventricular artery. The doctor used coronary artery optical coherence tomography (OCT) to accurately determine the size of the narrowed artery and placed a large stent. After the intervention, Mr. B. no longer had difficulty breathing and chest pain and was discharged after 2 days.

OCT is an advanced imaging technique that uses light to create high-resolution images of the blood vessels, allowing doctors to clearly observe the structure of atherosclerotic plaques and assess the condition of blood vessels in detail. Thanks to OCT, doctors can ensure that stents are maximally expanded and tightly adhered to the blood vessel wall, reducing the risk of restenosis and other complications.

Another case is Mr. T., 47 years old, was hospitalized with severe chest pain and diagnosed with ST-elevation myocardial infarction. The doctor placed a stent to re-open the coronary artery with the support of an intravascular ultrasound system (IVUS).

VUS is an advanced imaging technology that allows doctors to clearly see the internal structure of the coronary arteries. The IVUS device is inserted into the artery through a small catheter, emitting ultrasound waves to create detailed images of the artery and the structure of the atherosclerotic plaque. This helps doctors accurately assess the degree of narrowing and thickness of the atherosclerotic plaque, thereby choosing the appropriate size and location of the stent.

In addition, IVUS also helps detect potential complications such as unstable plaques, ruptures or thrombosis, thereby adjusting the intervention strategy to achieve optimal effectiveness and reduce the risk of restenosis. After the intervention, Mr. Thang no longer had chest pain and was discharged after 3 days.

Mrs. B., 89 years old, was admitted to the hospital in critical condition with acute myocardial infarction, heart failure and low blood pressure. She was diagnosed with severe calcification of the coronary artery, almost completely blocking the main blood flow.

In this case, the doctor decided to use the rotablator technique (diamond drill to cut the calcified plaque) to treat this severe calcification. The rotablator is a device that uses a small drill to grind and cut away calcified plaque in the artery, helping to restore blood flow and better prepare for stent placement.

The rotablator technique is of particular value in cases of severe arterial calcification, when conventional interventional methods are unlikely to be effective.

By removing calcified plaques, the rotablator helps ensure that the stent can expand to its maximum and adhere to the vessel wall, shortening the intervention time, reducing the risk of restenosis and improving treatment outcomes.

After using the rotablator to treat the calcified plaque, the doctors successfully placed a stent to reperfuse the blocked coronary artery. Immediately after the intervention, Mrs. Be's health improved significantly, her chest pain decreased and her blood pressure gradually stabilized.

According to People's Physician, Associate Professor Bach Yen, new techniques such as intravascular ultrasound (IVUS), coronary optical coherence tomography (OCT) and rotablator are new technological advances that help accurately assess coronary artery lesions, optimize coronary stent placement results, thereby optimizing treatment outcomes for patients.

In addition, even if the patient has been successfully treated with stent reperfusion, the problem of atherosclerosis still exists and can cause stenosis in other vascular locations (coronary arteries, carotid arteries, upper and lower limb arteries, etc.).

Therefore, patients need to change their lifestyle such as quitting smoking, eating foods low in cholesterol, limiting fat, salt, etc.; treating some related diseases such as diabetes, high blood pressure, dyslipidemia, etc.; and continuing to use some specific drugs for a long time... to treat and prevent recurrent myocardial infarction.