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Review
. 2014 Jun 26;6(6):381-92.
doi: 10.4330/wjc.v6.i6.381.

Coronary thrombus in patients undergoing primary PCI for STEMI: Prognostic significance and management

Sabine Vecchio  1 , Elisabetta Varani  1 , Tania Chechi  1 , Marco Balducelli  1 , Giuseppe Vecchi  1 , Matteo Aquilina  1 , Giulia Ricci Lucchi  1 , Alessandro Dal Monte  1 , Massimo Margheri  1
Affiliations
Review

Coronary thrombus in patients undergoing primary PCI for STEMI: Prognostic significance and management

Sabine Vecchio et al. World J Cardiol. .

Abstract

Acute ST-elevation myocardial infarction (STEMI) usually results from coronary atherosclerotic plaque disruption with superimposed thrombus formation. Detection of coronary thrombi is a poor prognostic indicator, which is mostly proportional to their size and composition. Particularly, intracoronary thrombi impair both epicardial blood flow and myocardial perfusion, by occluding major coronary arteries and causing distal embolization, respectively. Thus, although primary percutaneous coronary intervention is the preferred treatement strategy in STEMI setting, the associated use of adjunctive antithrombotic drugs and/or percutaneous thrombectomy is crucial to optimize therapy of STEMI patients, by improving either angiographical and clinical outcomes. This review article will focus on the prognostic significance of intracoronary thrombi and on current antithrombotic pharmacological and interventional strategies used in the setting of STEMI to manage thrombotic lesions.

Keywords: Antithrombotic therapies; Coronary thrombectomy; Intracoronary thrombosis; Primary percutaneous coronary intervention; ST-elevation myocardial infarction.

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