98%
921
2 minutes
20
ST-elevation myocardial infarction (STEMI) is a critical cardiovascular emergency characterized by acute coronary artery occlusion and subsequent myocardial injury. The current standard of care is primary percutaneous coronary intervention (PPCI), which aims to rapidly restore epicardial blood flow. However, despite successful revascularization, microvascular obstruction (MVO) remains a major challenge, contributing to adverse clinical outcomes. This article explores the potential role of intracoronary thrombolysis, in conjunction with thrombus aspiration, in improving microcirculatory perfusion during PCI for STEMI patients. The pathophysiology of MVO is systematically reviewed, followed by an evaluation of clinical studies on thrombus aspiration and intracoronary thrombolysis in STEMI management. Furthermore, the potential benefits of combining these two approaches in mitigating MVO are discussed. Finally, the clinical evidence is critically assessed, existing controversies are analyzed, and directions for future research are proposed.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985840 | PMC |
http://dx.doi.org/10.3389/fcvm.2025.1516054 | DOI Listing |
EuroIntervention
July 2025
Department of Cardiology and Angiology, Hannover Medical School, Hanover, Germany.
Background: Final infarct size (FIS) and microvascular obstruction (MVO) are associated with heart failure hospitalisations and mortality in patients with acute myocardial infarction (AMI). Interventions beyond primary percutaneous coronary intervention (PCI) to reduce FIS are needed. Supersaturated oxygen (SSO) therapy demonstrated reduced FIS in clinical trials.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
August 2025
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Background: Intravascular lithotripsy (IVL) is an innovative treatment for coronary artery calcification (CAC).
Aims: This study aimed to compare procedural and clinical outcomes of intracoronary imaging (ICI)-guided percutaneous coronary intervention (PCI) versus angiography-guided PCI with IVL in patients with CAC.
Methods: A total of 509 patients were analyzed from the BENELUX-IVL registry (May 2019 to September 2024).
REC Interv Cardiol
July 2024
Servicio de Cardiología Intervencionista, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina Servicio de Cardiología Intervencionista Instituto Cardiovascular de Buenos Aires Buenos Aires Argentina.
Introduction And Objectives: Drug-eluting balloons (DEB) are an established treatment option for in-stent restenosis (ISR). This study aimed to assess the safety and efficacy of a novel DEB in patients with ISR.
Methods: This prospective, single-center study enrolled a consecutive cohort of patients diagnosed with ISR who underwent coronary angioplasty with a new second-generation paclitaxel-eluting balloon.
Sci Rep
May 2025
ARTORG Center for Biomedical Engineering Research, University of Bern, Freiburgstrasse 3, 3008, Bern, Switzerland.
Coronary microvascular obstruction (MVO) occurs in up to 57% of patients suffering from ST-segment elevation myocardial infarction (STEMI). One cause for MVO is distal embolization by microthrombi after percutaneous coronary intervention (PCI) of the infarct-related coronary artery. MVO is associated with an adverse cardiac prognosis post-STEMI.
View Article and Find Full Text PDFZhonghua Xin Xue Guan Bing Za Zhi
May 2025
School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China.
To explore the feasibility of a coronary angiography-based method developed with artificial intelligence which was able to automatically and quickly calculate coronary volumetric blood flow and coronary flow reserve (CFR), and explore the differences in CFR after injection of different vasodilators. This was a observational study screening patients with suspected coronary artery disease who underwent coronary angiography From June to September 2022 in Fuwai Hospital, Chinese Academy of Medical Sciences. Patients without obstructive coronary artery disease in the left anterior descending artery (<50% diameter stenosis by visual) and accompanied by coronary slow flow phenomenon (Thrombolysis in Myocardial Infarction flow grade ≤2) were enrolled.
View Article and Find Full Text PDF