[Management of high thrombus burden in primary PCI]

L Mangin; M Lotfi; P Puie; K Yayehd; A Ispas; L Belle

doi:10.1016/j.ancard.2017.10.016

[Management of high thrombus burden in primary PCI]

Ann Cardiol Angeiol (Paris). 2017 Dec;66(6):380-384. doi: 10.1016/j.ancard.2017.10.016. Epub 2017 Oct 31.

[Article in French]

Authors

L Mangin¹, M Lotfi², P Puie², K Yayehd², A Ispas², L Belle²

Affiliations

¹ Service de cardiologie, centre hospitalier, 74000 Annecy, France. Electronic address: [email protected].
² Service de cardiologie, centre hospitalier, 74000 Annecy, France.

PMID: 29096903
DOI: 10.1016/j.ancard.2017.10.016

Abstract

A large thrombus burden is not uncommon in primary percutaneous coronary intervention, and is associated with more frequent complications. The role of intracoronary thrombolysis and glycoprotein IIb/IIIa inhibitors in the management of a large thrombus burden is discussed. The use of thromboaspiration must follow a particular logic and used with rigorous manipulations; the capacities of the protective filters are often exceeded. Stents dedicated to thrombus management can be used. Interest and limits of these stents are developed. Direct stenting should be encouraged, and delayed stenting probably considered for the most important thrombotic burden despite "negative" results in studies.

Keywords: Acute coronary syndrome; Syndrome coronarien aigu; Thromboaspiration; Thrombus.

MeSH terms

Angioplasty, Balloon, Coronary / methods
Coronary Thrombosis / therapy*
Humans
Meta-Analysis as Topic
Percutaneous Coronary Intervention / adverse effects*
Platelet Aggregation Inhibitors / therapeutic use*
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors
Stents*
Thrombectomy* / methods
Thrombolytic Therapy / methods
Treatment Outcome

Substances

Platelet Aggregation Inhibitors
Platelet Glycoprotein GPIIb-IIIa Complex