Enhancing microcirculation in STEMI patients: can intracoronary thrombolysis combined with thrombus aspiration provide an optimal strategy?
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....
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-03-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1516054/full |
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| author | DongDong Yan WenQiang Li Ming Bai Pei Wang Zheng Zhang |
| author_facet | DongDong Yan WenQiang Li Ming Bai Pei Wang Zheng Zhang |
| author_sort | DongDong Yan |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-d5c734ab8a5a431b83cdd77413d6395b |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-d5c734ab8a5a431b83cdd77413d6395b2025-08-20T03:44:28ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-03-011210.3389/fcvm.2025.15160541516054Enhancing microcirculation in STEMI patients: can intracoronary thrombolysis combined with thrombus aspiration provide an optimal strategy?DongDong Yan0WenQiang Li1Ming Bai2Pei Wang3Zheng Zhang4Department of Cardiology, First Hospital of Lanzhou University, Lanzhou, ChinaFirst Clinical Medical College of Lanzhou University, Lanzhou, ChinaDepartment of Cardiology, First Hospital of Lanzhou University, Lanzhou, ChinaFirst Clinical Medical College of Lanzhou University, Lanzhou, ChinaDepartment of Cardiology, First Hospital of Lanzhou University, Lanzhou, ChinaST-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.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1516054/fullST-elevation myocardial infarctionintracoronary thrombolysisthrombus aspirationMVOoptimal strategy |
| spellingShingle | DongDong Yan WenQiang Li Ming Bai Pei Wang Zheng Zhang Enhancing microcirculation in STEMI patients: can intracoronary thrombolysis combined with thrombus aspiration provide an optimal strategy? Frontiers in Cardiovascular Medicine ST-elevation myocardial infarction intracoronary thrombolysis thrombus aspiration MVO optimal strategy |
| title | Enhancing microcirculation in STEMI patients: can intracoronary thrombolysis combined with thrombus aspiration provide an optimal strategy? |
| title_full | Enhancing microcirculation in STEMI patients: can intracoronary thrombolysis combined with thrombus aspiration provide an optimal strategy? |
| title_fullStr | Enhancing microcirculation in STEMI patients: can intracoronary thrombolysis combined with thrombus aspiration provide an optimal strategy? |
| title_full_unstemmed | Enhancing microcirculation in STEMI patients: can intracoronary thrombolysis combined with thrombus aspiration provide an optimal strategy? |
| title_short | Enhancing microcirculation in STEMI patients: can intracoronary thrombolysis combined with thrombus aspiration provide an optimal strategy? |
| title_sort | enhancing microcirculation in stemi patients can intracoronary thrombolysis combined with thrombus aspiration provide an optimal strategy |
| topic | ST-elevation myocardial infarction intracoronary thrombolysis thrombus aspiration MVO optimal strategy |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1516054/full |
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