ANTIPLATELET THERAPY FOR CORONARY STENTIN G

Coronary stent implantation is today a catheterisation laboratory rout ine procedure for de novo lesions and less frequently for bail-out sit uations. Antithrombotic pharmacological regimens based upon coumadin h ave filed to prevent sub-acute stent thrombosis. The use of new antipl atelet therapy (ticlopidine alone or in association with aspirin) have reduced the sub-acute thrombosis rate to 1 %. Routine combining hepar in is not useful. The benefit of ultrasound guided stenting or high pr essure balloon expansion is not demonstrated in the thrombosis prevent ion. New pharmacological approaches inducing fibrinogen platelet recep tor antagonists (antii GP IIb - IIIa) may extend stent implantations m ore especially in acute coronary syndroms.