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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Acute Myocardial Infarction/Thrombectomy

Jonathan Soverow1, Manish A Parikh1

  • 1Center for Interventional Vascular Therapy, Columbia-Presbyterian Hospital, 161 Fort Washington Avenue, Herbert Irving Pavilion, 6th Floor, New York, NY 10032, USA.

Interventional Cardiology Clinics
|June 6, 2017
PubMed

Insights

This review covers advanced techniques for complex acute myocardial infarction cases, discussing controversies in device use and nonculprit lesion treatment. Recent trials have influenced guideline shifts regarding support devices and thrombectomy.

Area of Science:

  • Interventional Cardiology
  • Cardiovascular Medicine

Background:

  • Acute myocardial infarction (AMI) management involves complex decision-making, particularly in challenging cases.
  • Evidence gaps and evolving clinical trial data necessitate nuanced approaches to treatment strategies.

Purpose of the Study:

  • To review specialized techniques and devices for complex AMI cases.
  • To discuss controversies and recent guideline shifts in device use and nonculprit lesion management.

Main Methods:

  • Focused review of specialized techniques and devices in challenging AMI scenarios.
  • Analysis of recent practice-changing clinical trials influencing guideline recommendations.

Main Results:

  • Guidelines have shifted, downgrading routine use of assist devices in cardiogenic shock and aspiration thrombectomy.
  • Consideration for nonculprit coronary intervention has been re-evaluated and revived.

Conclusions:

  • Current evidence supports a more selective approach to mechanical circulatory support and thrombectomy in AMI.
  • The management of nonculprit lesions in AMI requires careful consideration based on evolving trial data and patient-specific factors.

Keywords:
Acute myocardial infarctionCardiogenic shockCulprit lesionThrombectomy

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