Introduction
Acute coronary events are commonly caused by plaque rupture, erosion and, infrequently, calcific nodules. In the majority of patients with acute coronary syndrome (ACS), occlusive or sub-occlusive thrombus on top of plaque deformation is the main angiographic finding. Resolving acute thrombotic occlusion remains the cornerstone step in restoring adequate coronary perfusion. Blind dealing with thrombi, depending only on angiography, may be an obstacle to optimal myocardial perfusion and increase in-hospital morbidity and mortality.1–4
In the past, intravascular ultrasound (IVUS) and, more recently, optical coherence tomography (