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Two large randomized controlled trials have demonstrated that routine manual thrombectomy is not beneficial in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI) and was associated with an elevated stroke rate within 30 days (N Engl J Med 2013; 369:1587 and N Engl J Med 2015; 372:1389). Although thrombectomy significantly improved early surrogate outcomes of distal embolization and ST-segment resolution, its effect on hard endpoints at 1 year is unknown.
Now, long-term results from the TOTAL trial — sponsored by the manufacturer of the aspiration thrombectomy device — are reported. A total of 10,064 patients with STEMI who underwent index PCI and thrombectomy in a 1…