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World J Cardiol. Sep 26, 2014; 6(9): 924-928
Published online Sep 26, 2014. doi: 10.4330/wjc.v6.i9.924
Thrombus aspiration in acute myocardial infarction: Rationale and indication
Gennaro Sardella, Rocco Edoardo Stio
Gennaro Sardella, Rocco Edoardo Stio, Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, “Sapienza” University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Author contributions: Sardella G designed and performed the research; Stio RE wrote the paper.
Correspondence to: Gennaro Sardella, MD, FACC, FESC, Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, “Sapienza” University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy. rocco.stio@libero.it
Telephone: +39-06-49979035 Fax: +39-06-49979060
Received: December 20, 2013
Revised: July 11, 2014
Accepted: July 17, 2014
Published online: September 26, 2014
Processing time: 282 Days and 3.2 Hours
Core Tip

Core tip: Distal coronary embolization occurs predominantly at the time of the initial balloon or stent inflation, so thrombus burden reduction by thrombectomy devices before percutaneous coronary intervention may decrease the dangerous phenomenon of no-reflow. Manual aspiration catheters are the most commonly used devices. Several randomized trials have demonstrated the efficacy and safety of pretreatment with manual thrombectomy during primary percutaneous coronary intervention. There are some unanswered questions about thrombus aspiration, including whether there is truly a mortality benefit, which subgroups may or may not benefit from aspiration, and whether patients with a large thrombus burden are better treated with mechanical thrombectomy.