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Distal embolization of fragmented thrombi during mechanical reperfusion of occluded coronary arteries is considered a major limitation of primary percutaneous coronary intervention (PCI). Small trials have suggested that thrombectomy is beneficial, but results of a larger trial were conflicting (NEJM JW Cardiol Oct 2014 and N Engl J Med 2014; 371:1111).
In an international multicenter trial sponsored by the manufacturer of a thrombectomy device, 10,732 patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI were randomized to a strategy of upfront thrombectomy preceding PCI or PCI alone.
At 6 months, rates of the primary composite outcome (cardiovascular death, recurrent MI, cardiogenic shock, or New York Heart…