Approaches to mechanical coronary thrombectomy

Coronary thrombi are an integral part of acute coronary syndromes. Since the introduction of the AngioJet Rheolytic thrombectomy device in 1999, mechanical thrombectomy has replaced intracoronary thrombolysis during catheter-based procedures. Other approaches include simple suction aspiration, cut and aspirate devices and clot disruption by ultrasound or laser-induced cavitation. These device classes differ in the completeness of thrombus removal, ease of use, complication profile, as well as clinical evidence of benefit. The current approaches to mechanical thrombectomy are reviewed from these perspectives.