Does combined anti-platelet therapy with ASA and ticlopidine prevent sustained platelet activation and slow-flow phenomenon after successful PTCA and lysis for a large intracoronary thrombus in AMI?
Sustained platelet activation and progressive slow-flow phenomenon can occur despite combined anti-platelet therapy following successful treatment of a large intracoronary thrombus in AMI.
A patient with AMI caused by a large thrombus in the proximal LAD was successfully treated with PTCA and an intracoronary lysis combined with the platelet-receptor antagonist c7E3. Analysis of cellular hemostasis after 1 and 6 months revealed a sustained platelet activation despite combined anti-platelet therapy with ASA and ticlopidine. A progredient slow-flow phenomenon appeared during control angiographies, confirmed by intracoronary Doppler examination.
Haude et al. (Sun,) studied this question.