ABSTRACT

Epicardial arterial occlusion secondary to coronary thrombosis has long been recognized as the predominant mechanism underlying the clinical presentation of acute ST segment elevation myocardial infarction (STEMI) (1). Expeditious restoration of normal coronary flow is the goal of medical intervention, in order that the metabolic needs of the jeopardized myocardium may be resupplied as rapidly as possible and the extent of irreversible myocardial damage be minimized. Mechanical flow restoration in the setting of STEMI was first reported by Rentrop et al. in 1979 (2). Since then primary angioplasty has emerged as the reperfusion modality of choice. Specifically, a primary angioplasty reperfusion strategy has proven superior to thrombolytic therapy in terms of both early and late survival-findings driven by higher rates of achieved vessel patency (TIMI 3 flow), enhanced stability of vessel reopening (reduced incidence of reinfarction), and lower rates of stroke (3,4).