Currently, the preferred treatment of persistent ST-segment elevation acute myocardial infarction is primary angioplasty. After successful primary angioplasty, up to 30% of patients develop left ventricular dilation and heart failure, as a result of incomplete microvascular reperfusion. The pathophysiology of the microvascular dysfunction in the setting of primary angioplasty is complex and not completely known. Distal embolization of necrotic and thrombotic material acts as a mayor factor. No treatment has so far demonstrated proven efficacy in this scenario. However, several prophylactic measures have been identified. Among them, the rheolytic trombectomy offers interesting benefits both in surrogate and clinical outcome variables.
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