[Our enemy : the clot. Coronary thrombosis : strategy and therapeutic arsenal]

Area of Science:

• Cardiology
• Interventional Cardiology
• Thrombosis Research

Background:

• Intracoronary thrombus is frequently observed during acute coronary syndromes revascularization and less commonly during stable angina angioplasty.
• The presence of thrombus poses risks for poor angiographic outcomes and prognosis due to potential coronary occlusion or distal embolization.

Purpose of the Study:

• To review the implications of intracoronary thrombus in angioplasty procedures.
• To discuss current strategies for thrombus prevention and treatment, including thrombectomy and GPIIb/IIIa inhibitors.
• To highlight the complexities of the no-reflow phenomenon and its relation to thrombotic complications.

Main Methods:

• Review of existing literature on intracoronary thrombus during percutaneous coronary interventions.
• Analysis of current practices in antithrombotic therapy and interventional strategies.
• Discussion of the challenges in managing thrombotic complications and the no-reflow phenomenon.

Main Results:

• Intracoronary thrombus is a significant factor impacting procedural success and patient prognosis.
• Optimal antithrombotic treatment and careful procedural planning are key for thrombus prevention.
• Treatment of established thrombus, including thrombectomy and GPIIb/IIIa inhibitors, remains a subject of ongoing debate and clinical practice.

Conclusions:

• Current mechanical and pharmacological antithrombotic therapies should be judiciously applied based on clinical and angiographic context.
• Further research is needed to clarify optimal treatment strategies for intracoronary thrombus and associated complications like no-reflow.
• Adherence to established antithrombotic protocols is essential pending further scientific advancements.