[Thrombus aspiration therapy for acute coronary syndrome].

Reducing thrombus burden before percutaneous coronary intervention (PCI) may lead to better myocardial reperfusion in patients with acute myocardial infarction (AMI). Thus, several types of devices have been developed to remove intracoronary thrombus during reperfusion therapy, which includes X-sizer, AngioJet, and aspiration devices. There are two important randomized studies by using X-sizer and AngioJet to evaluate the efficacy of thrombus removal, which implied the possible benefit in myocardial tissue reperfusion, but could not prove the beneficial impact on clinical outcomes. As for thrombus aspiration, there also seems to be no data to demonstrate its clinical impact on prognosis. However, the aspiration therapy has been accepted widespread in Japan, mainly because of the practical benefit to clarify the lesion morphology with easy manipulation. Further studies are needed to demonstrate the characteristics of patient or lesion characteristics which are likely to benefit most by thrombus removal therapy or which demand to perform distal protection strategy.