[Coronary thrombosis--an old concept in a new light]

The morphologic-clinical links in acute myocardial ischemia have been established in the last few years. Angiographic and biochemical investigations have contributed to the understanding of the connection between the acute coronary lesion (fissure or rupture of a plaque, dissection) and the dynamic process of thrombus formation, lysis and coronary spasm that occur during the first minutes and hours of acute myocardial ischemia. Deep arterial lesions with thrombotic tendency also occur after coronary bypass operations, thrombolysis and PTCA. Conventional antithrombotic substances like aspirin and heparin are only partially effective, and new compounds are tested which either inhibit platelet aggregation or thrombin formation more completely. Hopefully, these new drugs will prevent reocclusion after thrombolysis and restenosis after PTCA more effectively.