McMaster Textbook of Internal Medicine

McMaster Textbook of Internal Medicine
Interviews
Cardiology
Thrombectomy in patients with STEMI undergoing PCI

Thrombectomy in patients with STEMI undergoing PCI

2018-08-03

Zaza Iakobishvili

Recorded at the 4th McMaster International Review Course in Internal Medicine (MIRCIM).

In which patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) should we perform thrombectomy?

Zaza Iakobishvili, MD, PhD: According to the last guidelines thrombectomy is contraindicated, but there is an important addition: routine use of thrombectomy. Thrombectomy by itself is not abandoned but reserved only for patients with very, very high thrombotic burden. In these cases, we can occasionally do thrombectomy but [only] in patients with very high thrombotic burden and if the operator feels good with this equipment. But the routine use of thrombectomy is abandoned. It is contraindicated.

See also

Urgent coronary angiography after cardiac arrest Which patients after cardiac arrest should undergo urgent coronary angiography? Should they be transported to an intensive care unit (ICU) first or directly to a catheterization laboratory?
Diuretic treatment in heart failure How to plan diuretic treatment in patients with heart failure to prevent volume overload? Should the treatment be based on the presence of edema or other symptoms or on B-type natriuretic peptide (BNP) levels?
Heparin in a patient with MI on anticoagulation Should heparin be administered in a patient with myocardial infarction (MI) who is already on long-term oral anticoagulants?
Hypertension in the elderly and universal BP targets Dr Franz H. Messerli discusses treatment of hypertension in the elderly patients, the idea of setting universal blood pressure targets, and the results of SPRINT in a conversation with Dr Jerzy Gąsowski.
Acute heart failure: management according to the latest ESC guidelines A lecture by Prof. Piotr Ponikowski, from Wrocław Medical University, Poland, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2016.
Managing NSTE acute coronary syndromes in 2016 A lecture by Prof. Sanjit Jolly, from McMaster University, Canada, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2016.

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