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Coronary interventions: Thrombus Aspiration, Pros and Cons

  • Mark J. Schneider
  • James C. Blankenship
Chapter

Abstract

Coronary thrombus is often present in acute ST-segment myocardial infarction (STEMI) and complicates coronary revascularization. Thrombus increases the technical complexity of coronary stenting and can embolize downstream during PCI, resulting in macro- and microvascular obstruction. In the late 1990s, thrombectomy devices were first tested as adjunctive therapy to primary PCI in STEMI patients. Early trials suggested that aspiration thrombectomy (AT) improved surrogate and clinical endpoints. However, subsequent larger trials and meta-analyses of AT found no mortality benefit and possibly an increased incidence of stroke. The future of AT is uncertain, although it seems likely that it will continue to be used selectively but not routinely by interventionists.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Geisinger Medical Center Department of Interventional CardiologyDanvilleUSA

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