Effects of complete or partial occlusion of a coronary artery.

ABSTRACT

We investigated the effects of a partial compared to a complete thrombotic occlusion of the left anterior descending coronary artery in dogs. A completely occlusive thrombus was associated with a full thickness myocardial infarction. Mural thrombus was associated with focal areas of myocardial injury, mainly subendocardial in location. The findings are compatible with the concept that mural thrombus can give rise to platelet or platelet-fibrin emboli in the microcirculation which cause focal areas of ischemic damage. This pathogenesis was further explored using a thrombogenic wire placed in the left anterior descending coronary artery by indirect technique. Five of 10 dogs had developed a completely occlusive thrombus, whereas five had a mural thrombus at death, which occurred within 2 days. Three of the five dogs with mural thrombus had focal ischemic myocardial damage and platelet-fibrin thrombi; the other two that died early showed only platelet fibrin masses in the microcirculation. When platelets were labeled with 111Indium, there was increased radioactivity in the territory of the myocardium served by the artery containing a developing thrombus.