title: Coronary intervention in thrombus-rich lesions: beyond stents and glycoprotein IIb/IIIa inhibitors.
abstract: Despite widespread use of stents and GP IIb/IIIa antagonists, complications following percutaneous treatment of thrombus-rich lesions continue to plague patients with ACS. In these patients the angiographically evident coronary thrombosis may represent a high degree of thrombus burden, which leads to a higher level of microembolization and its clinical sequelae. New catheter-based thrombus burden reduction systems and distal protection devices show promise for improving the prognosis of these high risk patients by decreasing distal microembolization, and thereby preventing myonecrosis. Careful procedural timing and patient selection are also likely to improve outcomes and resource utilization in the management of ACS patients.
authors.affiliation: Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Halkin
authors.forename: Gad
authors.initials: G
authors.lastname: Keren
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.forename: David R
authors.initials: DR
authors.lastname: Holmes
authors.forename: Uri
authors.initials: U
authors.lastname: Rosenschein
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications / Q000503:physiopathology; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D012212:Rheology / Q000295:instrumentation / Q000379:methods; D012422:Rupture, Spontaneous / Q000209:etiology / Q000503:physiopathology; D013396:Suction / Q000295:instrumentation / Q000379:methods; D017131:Thrombectomy / Q000295:instrumentation / Q000379:methods; D015912:Thrombolytic Therapy / Q000379:methods; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods