ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
59
INNOVATIVE INTERVENTIONAL APPROACHES TO CORONARY
ARTERY THROMBOSIS IN ACUTE CORONARY SYNDROME
Askarov Shakhzod Shavkat ugli
Salakhitdinov Shukhrat Najmitdinovich
Jizzakh branch of the Republican Scientific Center for Emergency Medical Care,
Head of the Angiography Department
Deputy Director for Medical Work at the National Children's Center
https://doi.org/10.5281/zenodo.15797223
Abstract
This study analyzes the clinical and angiographic outcomes of various
interventional strategies used in the treatment of total coronary artery
thrombosis in patients with acute coronary syndrome (ACS). A total of 120
patients were included and divided into groups based on the method of
intervention: standard PCI, thrombus aspiration, GP IIb/IIIa inhibitors, and
intravascular imaging (IVUS/OCT). Key outcomes included TIMI flow,
myocardial blush grade, and 30-day MACE (major adverse cardiac events).
Results revealed that combined approaches showed superior reperfusion
outcomes and reduced complications. The findings suggest that personalized,
multimodal interventional strategies are more effective in managing total
thrombotic occlusions.
Keywords:
Acute coronary syndrome, total thrombus, PCI, thrombus aspiration, GP IIb/IIIa
inhibitors, IVUS, OCT, TIMI flow, MACE.
Relevance
Total coronary artery thrombosis is among the most critical forms of acute
coronary syndrome (ACS), often leading to extensive myocardial damage and
high mortality. Immediate and effective reperfusion is essential to prevent
irreversible ischemic injury. While percutaneous coronary intervention (PCI)
remains the cornerstone of treatment, the choice of technique in the setting of
heavy thrombotic burden remains controversial. Recent advances such as
thrombus aspiration, potent antiplatelet therapy (e.g., GP IIb/IIIa inhibitors),
and intravascular imaging technologies (IVUS, OCT) offer promising solutions.
However, standardized protocols for their optimal use in total occlusions are
lacking. Comparative analysis of these strategies is vital to identify the most
effective approach, reduce adverse events, and improve patient outcomes. This
study provides critical insights into the clinical utility of different interventional
methods and supports the need for algorithm-based, individualized treatment in
patients with ACS and complete coronary artery occlusion.
ACADEMIC RESEARCH IN MODERN SCIENCE
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Aim of the Study:
To compare the clinical effectiveness of various interventional techniques
in the treatment of total coronary artery thrombosis in patients with acute
coronary syndrome.
Materials and Methods
A prospective cohort study was conducted involving 120 patients with
angiographically confirmed total coronary artery occlusion and acute coronary
syndrome. Patients were assigned to groups based on intervention type: (1)
standard PCI, (2) thrombus aspiration, (3) use of GP IIb/IIIa inhibitors, and (4)
multimodal approach with intravascular imaging (IVUS/OCT). Outcomes
measured included TIMI flow grade, myocardial blush grade, and 30-day MACE
(myocardial infarction, reocclusion, death). Statistical analysis included chi-
square tests and ANOVA to assess intergroup differences. Data on procedure
time, stent optimization, and complications were also recorded to determine
technical and clinical efficacy.
Results
The highest rate of optimal reperfusion (TIMI 3) was achieved in the
multimodal group (90%), compared to 65% in the standard PCI group (p<0.01).
Blush grade III was observed in 82% versus 57%, respectively. The 30-day
MACE rate was significantly lower in the multimodal group (6.5% vs. 18.8%;
p<0.05). Thrombus aspiration reduced thrombotic load, while IVUS/OCT
improved stent sizing and positioning. Use of GP IIb/IIIa inhibitors enhanced
microvascular perfusion. Overall, combination therapy demonstrated superior
angiographic and clinical outcomes compared to isolated interventions,
highlighting the need for a tailored strategy based on thrombus burden and
lesion morphology.
Conclusion
Comparative analysis indicates that a multimodal interventional approach—
incorporating thrombus aspiration, GP IIb/IIIa inhibitors, and intravascular
imaging—yields the best clinical and angiographic outcomes in total coronary
thrombosis. This strategy facilitates optimal stent deployment, improves
reperfusion metrics, and lowers the incidence of major adverse events. Standard
PCI alone is less effective in managing complex thrombotic lesions. Findings
support the routine incorporation of advanced techniques into treatment
protocols for high-risk ACS patients with total occlusion. Personalized
ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
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interventional strategies should become standard practice to maximize
procedural success and enhance survival in this critical patient population.
Literature:
1.
Абдурахманов М. М., Абдуллаева М. А., Умаров Б. Я. Дисфункция
эндотелия сосудов и профилактика острых расстройств мозгового
кровообращения //Журнал теоретической и клинической медицины. –
2019. – №. 1. – С. 29-31.
2.
Khamdamov B. Z., Umarov B. Y. COMBINED LOCAL TREATMENT OF LONG-
TERM NON-HEALING WOUNDS://Collection of abstracts of the scientific and
practical conference «Current Problems of Surgical Soft Tissue
Infections»(2024), Tashkent, October 28 //JOURNAL OF EDUCATION AND
SCIENTIFIC MEDICINE. – 2024. – Т. 1. – №. 5. – С. 7-8.
3.
Умаров Б. Я., Мемиров Б. М., Латыпова З. Г. ВЛИЯНИЕ САНИТАРНО-
ГИГИЕНИЧЕСКИХ УСЛОВИЙ ПРОЖИВАНИЯ НАСЕЛЕНИЯ И КАЧЕСТВА
ВОДОПРОВОДНОЙ ВОДЫ НА ЗАБОЛЕВАЕМОСТЬ ОСТРЫМИ КИШЕЧНЫМИ
ИНФЕКЦИЯМИ //Гигиена и санитария. – 1991. – №. 1. – С. 29-30.
