Coronary Artery Aspiration Thrombectomy

Acute ST-elevation myocardial infarction remains a major global cause of death and permanent disability. Management of thrombus in coronary vasculature presents a challenge that is commonly encountered during primary percutaneous coronary intervention. Thrombus burden has been associated with poor clinical outcomes and a greater number of adverse cardiac events. Various techniques and devices have been suggested for optimal management of such thrombi. We review the technology of aspiration thrombectomy and its utilization in the current era of thrombus retrieval. We highlight the landmark trials that have provided valuable data on the clinical outcomes of aspiration thrombectomy. We review and discuss the use of this technology in the management of patients presenting with ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, and acute ischemic stroke. Additionally, we highlight the differences between outcomes, theories that may explain these outcomes, and recommendations for further studies in this field.