Management of high thrombus burden during primary percutaneous coronary intervention

Managing high thrombus burden during primary percutaneous coronary intervention (PCI) poses significant challenges and is associated with increased procedural complications and adverse clinical outcomes. This abstract reviews current strategies and controversies surrounding the treatment of high thrombus burden in patients undergoing PCI. It discusses pharmacological approaches such as potent antiplatelet agents, glycoprotein IIb/IIIa inhibitors, and novel antithrombotic therapies, alongside mechanical strategies including thrombus aspiration and balloon angioplasty. The importance of individualized treatment based on clinical presentation, thrombus characteristics, and procedural factors is emphasized. Clinical trials and guidelines are reviewed to provide evidence-based recommendations for optimizing outcomes in this complex patient population. Future directions in research and technology aimed at further refining management strategies are also explored.