Protection devices and thrombectomy for native coronary artery ST-elevation myocardial infarction.
Distal thrombus embolization during primary percutaneous coronary intervention occurs frequently and is associated with compromised long term outcomes. Apart from pharmacological agents, great interest has recently been shown in various mechanical devices aimed at either reducing the amount of thrombus present or preventing its distal migration. However, despite the intuitive appeal of such devices, their application remains uncertain given the results of emerging randomized trials. Data presently available show a significant discrepancy between softer clinical endpoints such as reperfusion markers and hard clinical outcomes. The purpose of this review is to summarize the current clinical evidence and provide guidelines for their use.
Gurvitch
Ronen
R
Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia.
Ajani
Andrew E
AE
Yan
Bryan P
BP
Waksman
Ron
R
D015906:Angioplasty, Balloon, Coronary; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery*; D004617:Embolism / Q000517:prevention & control*; D005374:Filtration; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D009203:Myocardial Infarction / Q000503:physiopathology / Q000601:surgery*; D017131:Thrombectomy / Q000295:instrumentation* / Q000379:methods