ABSTRACT
Large thrombus burden • Pharmacological approaches • Mechanical approaches • Slow-flow, no-reflow • Distal embolization • Summary
Thrombus-containing lesions often represent the pathological substrate of a group of clinical entities known as acute coronary syndromes (ACS). Acute coronary syndromes may present with clinical manifestations which range from unstable angina pectoris, non-ST segment elevation myocardial infarction (NSTEMI), or the classic ‘transmural’ or ST segment elevation myocardial infarction (STEMI). They all share a common pathophysiology, namely, a ‘vulnerable’ atherosclerotic coronary plaque suddenly ruptures, exposing thrombogenic material to circulating platelets and coagulation factors, which ultimately lead to the formation of thrombus.1-4 Depending upon the thrombus size, the intrinsic fibrinolytic system, platelet activation, and collateral flow, among others, the clinical presentation will differ in each instance.
