Weber M A, Lorenz R L, Schramm W, Theisen K
Z Kardiol. 1986;75 Suppl 5:107-11.
An endothelial injury that leads to local thrombogenicity is produced during angioplasty and persists after successful thrombolysis. Thus the risk of thrombosis is augmented after these interventions. The high grade coronary stenosis remaining after lysis increases the shear forces, again stimulating thrombus formation. A higher recurrence rate after angioplasty is seen in the presence of a wall thrombus. Therefore antithrombotic therapy is of importance not only for prophylaxis of reocclusion but also for prevention of restenosis after angioplasty. During angioplasty reduction of wall thrombus formation by acetylsalicylic acid in addition to heparin could be shown, and is likely after lysis. A low dose regimen of acetylsalicylic acid appears to be as effective as high dose treatment and minimizes adverse gastrointestinal reactions. A reduction of thrombotic occlusions of about 50% seems possible. The platelet inhibiting effects of beta blockers an Ca antagonists are not of clinical importance. There is no perfect antiplatelet agent for prophylaxis of occlusion and restenosis, so a combination of drugs with different modes of action may be necessary.
