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Lookup NU author(s): Dr Mohammad Alkhalil
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© 2024 by the authors.Optimal myocardial reperfusion during primary percutaneous coronary intervention (pPCI) is increasingly recognized to be beyond restoring epicardial coronary flow. Both invasive and non-invasive tools have highlighted the limitation of using this metric, and more efforts are focused towards achieving optimal reperfusion at the level of the microcirculation. Recent data highlighted the close relationship between thrombus burden and impaired microcirculation in patients presenting with ST-segment elevation myocardial infarction (STEMI). Moreover, distal embolization was an independent predictor of mortality in patients with STEMI. Likewise, the development of no-reflow phenomenon has been directly linked with worse clinical outcomes. Adjunctive thrombus aspiration during pPCI is intuitively intended to remove atherothrombotic material to mitigate the risk of distal embolization and the no-reflow phenomenon (NRP). However, prior trials on the use of thrombectomy during pPCI did not support its routine use, with comparable clinical endpoints to patients who underwent PCI alone. This article aims to review the existing literature highlighting the limitation on the use of thrombectomy and provide future insights into trials investigating the role of thrombectomy in contemporary pPCI.
Author(s): Satti Z, Omari M, Bawamia B, Cartlidge T, Egred M, Farag M, Alkhalil M
Publication type: Review
Publication status: Published
Journal: Journal of Clinical Medicine
Year: 2024
Volume: 13
Issue: 8
Online publication date: 15/04/2024
Acceptance date: 10/04/2024
ISSN (electronic): 2077-0383
Publisher: Multidisciplinary Digital Publishing Institute (MDPI)
URL: https://doi.org/10.3390/jcm13082291
DOI: 10.3390/jcm13082291
