Percutaneous coronary intervention (PCI) is the preferred method to treat ST segment myocardial infarction (STEMI). The use of thrombus aspiration (TA) may be particularly helpful as part of the PCI process, insofar as the presence of thrombus is essentially a universal component of the STEMI process. This article reviews evidence favoring the routine use of TA, and the limitations of these data. Based on current evidence, we consider TA to be an important maneuver during STEMI PCI, even in the absence of visible angiographic thrombus, and recommend it whenever the presence of thrombus is likely
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