Reocclusion following successful thrombolysis. Emerging concepts

Thrombolytic therapy, through the restoration of coronary arterial blood flow and myocardial perfusion significantly improves outcome among patients with acute myocardial infarction. Despite its widely appreciated benefits, however, thrombolysis removes only a small portion of existing thrombus at the site of atheromatous plaque rupture. Further, thrombogenic substrate is frequently exposed and may even be generated to the extent that rethrombosis occurs, causing recurrent ischemia, reinfarction, and coronary reocclusion. The mechanisms underlying this important event are discussed.