Thrombectomy devices

Introduction

Thrombus formation is an integral part of the pathophysiology of acute coronary syndromes. This makes an important difference in the choice of treatment strategy between planned percutaneous coronary intervention (PCI) in stable patients and urgent PCI in acute myocardial infarction (MI). The treatment of thrombotic lesions includes both mechanical intervention with selective use of thrombectomy devices, balloon predilatation or direct stenting technique as well as pharmacological treatment with oral and intravenous antiplatelet drugs (administered before or in the cath lab) and antithrombotic drugs. There is no single routine strategy beneficial for all patients with acute MI. Thus, the treatment should be planned individually for each patient as a tailored approach. In recent years, the role of thrombectomy devices during primary PCI has been studied extensively and such devices have been widely used in daily clinical practice. However, according to current thinking, more selective usage is recommended which makes the individual lesion judgement very important.

Treatment strategies for thrombotic lesions

It has been demonstrated that restoration of normal coronary flow in the infarct-related artery is not equivalent to the restoration of myocardial perfusion through the cardiac microcirculation. After conventional PCI with stent implantation and glycoprotein (GP) IIb/IIIa blockade, the...