Mise au pointThrombo-aspiration dans l’infarctus du myocarde aigu avec sus-décalage du segment STThromboaspiration in primary angioplasty for ST elevation myocardial infarction

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.