Manual Thrombectomy During Primary Coronary Intervention in Acute Myocardial Infarction: A Brief Review

The no — reflow phenomenon occurs in one third of the patients treated with primary percutanous intervention for acute ST segment elevation myocardial infarction. In addition of the effect of prolonged ischaemia, also reperfusion injury contributes significantly to the microvascular damage in the perfusion territory of the infarct — related coronary artery. In the recent years there has been an increasing interest in the concept of adjunctive mechanical thrombectomy to improve outcomes in primary percutaneous coronary intervention. In the literature randomized trials of thrombectomy have provided conflicting results with no definitive evidence for efficacy. The recently published Thrombus Aspiration During Percutaneous Coronary Intervention in Acute Myocardial Infarction Study (the largest randomized study of a thrombectomy device) demonstrates that adjunctive treatment with aspiration and manual thrombectomy improves clinical end — point. The aim of the report is to review the evidence to our date on the role of mechanical thrombectomy during primary percutaneous intervention in the setting of acute myocardial infarction.