Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

Atherosclerotic plaque disruption is a key event in the pathophysiology of acute coronary syndromes (ACS). Intraluminal thrombus is probably a universal feature of ACS as it is predominantly responsible for the accelerated process of vessel occlusion or subocclusion that characterizes the spectrum of ACS, from ST elevation ACS to non-ST-elevation ACS. This chapter describes an interventional approach to managing thrombus-containing coronary lesions. Intracoronary intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have higher sensitivity and specificity than angiography and allow better thrombus definition, quantification, and characterization. Two main kinds of thrombectomy devices are available: manual and mechanical. Manual thrombus aspiration devices consist of 6 Fr compatible dual lumen catheters. Two parameters determine the efficacy of a manual thrombectomy: deliverability and aspiration rate. With mechanical thrombectomy devices the thrombus is first lysed before extraction. Excimer laser coronary angioplasty (ELCA) is used to reduce thrombotic burden.

Original publication

DOI

10.1002/9781118983652.ch23

Type

Chapter

Book title

Interventional Cardiology: Principles and Practice

Publication Date

21/11/2016

Pages

233 - 243