a Mohammad Alian - Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

Prevalence of Thrombus containing lesions differ in various types of clinical settings, from 5-17% in Stable angina to 75-90% in ACS and 100% in ST elevation MI. Thrombus needs be cleared away to restore flow by Fibrinolytic agents, thrombus dislodgement in percutaneous Intervention and Thrombectomy.Thrombectomy intuitively was attractive based on well defined pathophysiology which prevent distal embolization and no reflow and reducing thrombotic burden and routine use of Aspiration Thrombectomy was class IIa till 2012 and TAPAS and other Trials showed clinical benefits , while then other larger trials such as TASTE,INFUSE-AMI ,TOTAL and TATORT and some others havenot shown clinical benefits and cause more Stroke and these trial changed the mention and guidelines of routine Aspiration thrombectomy as class III in Primary PCI.Embolic protective Devices (EPDs) is classified as Filter – based, Proximal occlusion and Distal occlusion devices and their use in STEMI as routine isn t suitable and increase stent thrombosis and TVR and TLR , But EPDs is class I for old SVGs.