Aspiration of Embolized Thrombus During Primary Percutaneous Coronary Intervention

During percutaneous coronary intervention for acute myocardial infarction, distal embolization of thrombus and plaque material often occurs, despite the use of thrombectomy and aspiration catheters. Large embolized thrombi can cause occlusion of distal coronary vessels for which angioplasty most often leads to no more than poor results. We describe the successful use of an aspiration catheter to treat distally embolized thrombus, to optimize coronary reperfusion therapy, and to improve salvage of myocardial tissue. We discuss the manifestation and incidence of distal embolization and show its clinical relevance. (C) 2009 Wiley-Liss, Inc.