• Arthur Rusovici, Santosh Varkey, Qaisra Saeed, Marc Klapholz, Bunyad Haider, and Edo Kaluski.
• University Hospital and New Jersey Medical School University of Medicine and Dentistry, Newark, NJ 07101, USA.
• Cardiovasc Revasc Med. 2011 Mar 1;12(2):133.e1-6.

AbstractArterial thrombosis and especially coronary thrombosis are known complications of cocaine abuse. We report three cases of severe life-threatening coronary arterial thrombosis manifesting as acute coronary syndromes. Thrombosis occurred predominantly in the proximal coronary tree with spontaneous distal embolization. The thrombotic occlusions were frequently not superimposed on flow-limiting atherosclerotic lesions. Treatment of these patients with thrombolytic, antithrombotic and anti-platelet therapy resulted in thrombus and symptom resolution. While stenting these vessels can be successfully executed and may be required in some cases of ST-elevation myocardial infarction, it may expose these patients to the risk of stent thrombosis, which is reported to be significantly higher than the risk of the general population.Copyright © 2011 Elsevier Inc. All rights reserved.

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