Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion modality in patients with ST-elevation myocardial infarction (STEMI). While PPCI is highly effective in achieving epicardial coronary reperfusion, a significant proportion of patients fail to achieve adequate myocardial reperfusion. This is in part due to the distal microembolisation of thrombus and plaque debris during PCI. Recognition of this has led to the development of a number of devices with different mechanisms of action that aim to reduce such distal embolisation and therefore improve end myocardial perfusion. Study results of thrombectomy devices however have been largely inconsistent, especially about clinical outcome data, and several meta-analyses have been carried out as a result. This review aims to critically analyse the literature data on thrombectomy during PPCI, taking into account the most recent studies and the latest metaanalyses looking to see whether thrombectomy use is associated with improved outcomes.
Krishnaraj S Rathod - Department of Cardiology, Barts Health NHS Trust; Department of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University, London; NIHR Cardiovascular Biomedical Research Unit, London Chest Hospital, London
Stephen M Hamshere - Department of Cardiology, Barts Health NHS Trust; NIHR Cardiovascular Biomedical Research Unit, London Chest Hospital, London
Tawfiq R Choudhury - Department of Cardiology, Barts Health NHS Trust; NIHR Cardiovascular Biomedical Research Unit, London Chest Hospital, London
Daniel A Jones - Department of Cardiology, Barts Health NHS Trust; Department of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University, London; NIHR Cardiovascular Biomedical Research Unit, London Chest Hospital, London
Anthony Mathur - Department of Cardiology, Barts Health NHS Trust; Department of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University, London; NIHR Cardiovascular Biomedical Research Unit, London Chest Hospital, London