Abstract

Primary angioplasty is the gold standard for myocardial reperfusion in patients with acute myocardial infarction with ST elevation (STEMI). Fast normalization of infarct-related coronary artery flow and no reflow prevention are correlated with clinical outcomes. Over the last years, many antithrombotic regimens have been evaluated in this setting. The use of a combined pharmacological and mechanical strategy with abciximab, and thromboaspiration of atherothrombotic debris is associated with coronary flow improvement, improvement of myocardial perfusion, and, in fine a better clinical outcome. In this respect, the current guidelines recommend a systematic manuel catheter thromboaspiration of the culprit lesion in STEMI with a class IIa, level of evidence A indication.

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