Role of thrombectomy in acute myocardial infarction.
Acute ST elevation myocardial infarction results from atherosclerotic plaque rupture with subsequent thrombus formation, leading to complete or near complete occlusion of an epicardial coronary artery. Minimization of the mechanical obstruction from this thrombus remains the main goal of therapy in ST elevation myocardial infarction. Primary percutaneous coronary intervention for an ST elevation myocardial infarction appears to be the preferred mode of revascularization over thrombolytic therapy if the door-to-balloon time target of 90 min is achievable. The idea of reducing the thrombus burden with the use of devices as an adjunct to percutaneous coronary intervention is an attractive one. Several thrombectomy devices have been studied in randomized clinical trials, but no definitive conclusions have emerged, owing to conflicting results and variable clinical end points. This article intends to shed further light on the potential role of thrombectomy in the treatment of acute myocardial infarction.
Thomas
Manesh
M
Department of Internal Medicine: Cardiology, University of Tennessee Health Science Center, Memphis, TN 38104, USA. mthoma40@utmem.edu
Das
Kanak
K
Nanjundappa
Aravinda
A
Dieter
Robert S
RS
Das
Pranab
P
D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D050197:Atherosclerosis / Q000150:complications; D006801:Humans; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D017131:Thrombectomy / Q000379:methods*; D013927:Thrombosis / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors