Catheter-delivered ultrasound therapy for native coronary arterial thrombosis and occluded saphenous vein grafts

Acute coronary thrombosis, overlying ruptured atherosclerotic plaque, is the hallmark of myocardial infarction and unstable angina. Despite use of modern therapeutic modalities, including glycoprotein IIb/IIIa antagonists and stenting, intracoronary thrombus heralds an increased risk of serious complications following percutaneous coronary interventions (PCI). Abundant in vitro and in vivo experimental data have proven that ultrasound energy is capable of lysing intravascular thrombus without injuring the vessel wall. Expanding experience and technological advancements now allow us to use this tool in clinical practice. In this article we review the emergence of percutaneous ultrasonic thrombolysis as a safe and effective tool for treatment of patients in various clinical settings associated with coronary thrombosis.