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Editor's Note
January 9, 2019

Update on Aspiration Thrombectomy

Author Affiliations
  • 1Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts
  • 2Deputy Editor, JAMA Cardiology
JAMA Cardiol. Published online January 9, 2019. doi:10.1001/jamacardio.2018.4488

Current international practice guidelines for the treatment of patients with ST-segment elevation myocardial infarction do not endorse the routine use of manual aspiration thrombectomy (AT) at the time of primary percutaneous coronary intervention (pPCI) (recommendation class III, no benefit). Whether the selective use of AT is beneficial when used adjunctively for large thrombus burden or as a bailout strategy is uncertain (recommendation class IIb).1,2 A patient-level meta-analysis of 3 large randomized clinical trials identified trends toward reduced 30-day cardiovascular death and increased stroke or transient ischemic attack risks in a subgroup of patients with high thrombus burden treated with pPCI and AT vs pPCI alone.3