Why the study?
Optimal invasive management of intracoronary thrombus during primary PCI remains challenging, as large thrombus burden leads to complications and adverse outcomes without an established ideal strategy.
This review provides a 2025 appraisal of strategies for managing large intracoronary thrombus burden during primary PCI in STEMI patients.
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Provides 2025 synthesis of STEMI thrombus strategies; leaves optimal approach open pending randomized trials.
Large thrombus burden (LTB) has been reported in a significant number of patients admitted with ST-segment elevation myocardial infarction (STEMI) in contemporary practice.The optimal invasive management of intracoronary thrombus during primary percutaneous coronary intervention remains a major challenge for interventionists.LTB may lead to distal embolization, no or slow reflow, or embolization into a non-culprit vessel and is associated with adverse cardiovascular outcomes.Currently, no ideal management strategy is available.In this manuscript, the authors discuss the currently available strategies for managing LTB in patients presenting with STEMI.
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Dash et al. (2025) studied this question.
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