Mechanical Reperfusion for STEMI

Giuseppe De Luca, Alexandra Lansky

• Rationale and Organizational Aspects: Primary Angioplasty vs Thrombolysis: An Overview of Randomized Trials and Registry Data. Which Patient Should Be Transferred for Primary PCI? Pharmacological Facilitation in Primary Angioplasty: Myth or Reality? How to Organize Networks for Invasive Treatment of STEMI: Krakow Experience. Zwolle Experience. Linkoping Experience. Experience in the USA. Experience in Asia. Failed Thrombolysis: Rescue Angioplasty or Conservative Therapy? Primary PCI in Cardiogenic Shock and Out-of-Hospital Cardiac Arrest. Adjuncitve Pharmacotherapy: Oral Antiplatelet Therapy. Gp IIb-IIIa Inhibitors. Anticoagulation Therapy. Technical Aspects: Balloon Angioplasty or BMS? Drug-Eluting Stent: Weighing Costs and Benefits. Mechanical Prevention of Distal Embolization: Rationale and Trial Results. Distal Protection Devices: Tips and Tricks. Thrombectomy Devices: Tips and Tricks. Proximal Devices: Tips and Tricks. Haemodynamic Support in High-Risk Patients. Limitation of Infarct Size: Adjunctive Mechanical Devices. Radial Approach. OCT, IVUS and Angioscopy. Redefining the Success of Mechanical Reperfusion: ST-Segment Resolution. Myocardial Blush Grade and cTFC. Doppler Flow-Wire. MRI. Contrast Echocardiography. Nuclear Techniques. Special Issues: Bleeding Complications: Prognostic Implications, Prevention and Management. Contrast Induced Nephropathy: Prognostic Implications, Prevention and Management. A Glimpse into the Future: Myocardial Regeneration. Early Discharge after Primary PCI. Guidelines: ACC/AHA and ESC Guidelines.