Adjunctive thrombectomy in primary percutaneous intervention for acute XXXX .

@entity583 @entity1188 @entity715
Primary percutaneous coronary intervention (PCI) has become the favored reperfusion strategy in acute ST-segment elevation @entity583 . Lower post-PCI myocardial perfusion grade, no-reflow and even drug-eluting stent @entity715 have been related to the presence of intracoronary @entity715 . Adjunctive thrombectomy refers to procedures and devices that remove @entity715 material from the @entity1188 , in theory, before distal embolization can occur. There is substantial variability between randomized controlled trials of thrombectomy in primary PCI with regards to tested devices, procedural characteristics, adjuvant medical regimen and examined outcomes. As a general statement, improvements in myocardial perfusion endpoints do not translate into reductions in clinical outcomes. Yet, an increasing number of trials with a longer follow-up reported benefits arising late after the index @entity583 . Simple aspiration catheters may also produce better outcomes than devices that fragment the @entity715 before aspirating debris. Clinical or angiographic variables which best predict benefits from the use of thrombectomy remain to be defined. The aim of this review is to provide perspective on the conclusions of available trials and meta-analysis of adjunctive thrombectomy in acute @entity583 . Targets for future studies are discussed.
