[Antiplatelet therapy during coronary endoprosthesis placement]

Coronary stent implantation is today a catheterisation laboratory routine procedure for de novo lesions and less frequently for bail-out situations. Antithrombotic pharmacological regimens based upon coumadin have filed to prevent sub-acute stent thrombosis. The use of new antiplatelet therapy (ticlopidine alone or in association with aspirin) have reduced the sub-acute thrombosis rate to 1%. Routine combining heparin is not useful. The benefit of ultrasound guided stenting or high pressure balloon expansion is not demonstrated in the thrombosis prevention. New pharmacological approaches inducing fibrinogen platelet receptor antagonists (antii GP IIb-IIIa) may extend stent implementations more especially in acute coronary syndromes.