[Antithrombotic treatment in percutaneous transluminal coronary angioplasty].

Percutaneous transluminal coronary angioplasty is the most commonly used method for coronary revascularization in Norway. More than 3,500 procedures were performed in 1997. The presence of atherosclerotic endothelium is a strong stimulus to increased haemostasis. During balloon angioplasty, activation of the coagulation system is further increased by the trauma caused to the vessel wall. Major complications associated with coronary angioplasty include vessel occlusion, myocardial infarction, and periprocedural death. Most early complications occur as a result of the formation of a thrombus at the angioplasty site. Effective antithrombotic treatment is essential to reduce the risk of thromboembolic complications during and after percutaneous transluminal coronary angioplasty with or without stent implantation. All patients should be treated in advance with acetylsalicylic acid. Heparin must be given during the procedure. After stent implantation the patient should be treated with a combination of the two antiplatelet agents acetylsalicylic acid and ticlopidine. This article presents the current practice for using antithrombotic medication in percutaneous transluminal coronary angioplasty.