Interventional therapy for acute myocardial infarction: respect the microvasculature.

It is widely accepted that improved perfusion of viable myocardium preserves cardiac function and conveys longterm survival benefits after myocardial infarction (MI). Mechanical reperfusion for acute MI targets optimal revascularization of the epicardial artery but also aims at improved myocardial salvage. Intracoronary thrombus (especially large amounts) makes both of these goals difficult to achieve because attempts to maximize lesion-related outcomes may lead to embolization of thrombus distally with occlusion of the microvasculature and with actual prevention of myocardial salvage.