Xiao Y, Fu X, Wang Y, et al. - Among patients undergoing primary percutaneous catheterization for ST-elevation myocardial infarction (STEMI), researchers assessed if thrombus aspiration and intracoronary-targeted thrombolysis are safe and effective for treating coronary thrombus burden, they compared the influences of these on myocardial perfusion via index of microcirculatory resistance and single-photon emission computed tomography. Random allocation of STEMI patients showing high thrombus burden and undergoing primary catheterization was done to receive thrombus aspiration (TA group) or intracoronary thrombolysis (IT group). During a 90-day follow-up and a 12-month follow-up following the procedure, the evaluation of major adverse cardiovascular events and complications was performed. The IT group and the TA group included 38 and 33 patients, respectively. Findings revealed the efficacy as well as the safety of thrombus aspiration and intracoronary-targeted thrombolysis as strategies in treating high coronary thrombus burden in STEMI patients. More benefits on improving myocardial microcirculation perfusion were conferred by intracoronary-targeted thrombolysis vs aspiration.