PCI indicates percutaneous coronary intervention; and STEMI, ST-elevation myocardial infarction. 2015 Focused Update Recommendations Comments Class IIa Class IIb Manual aspiration thrombectomy is reasonable for patients undergoing primary PCI.[29 32] (Level of Evidence: B) The usefulness of selective and bailout aspiration thrombectomy in patients undergoing primary PCI is not well established.[33 37] (Level of Evidence: C-LD) Modified recommendation (Class changed from IIa to IIb for selective and bailout aspiration thrombectomy before PCI). Class III: No Benefit Routine aspiration thrombectomy before primary PCI is not useful.[33 37] (Level of Evidence: A) New recommendation ( Class III: No Benefit added for routine aspiration thrombectomy before PCI). PCI indicates percutaneous coronary intervention; and LD, limited data. PCI indicates percutaneous coronary intervention; and STEMI, ST-elevation myocardial infarction. 2015 ACC/AHA/SCAI Focused Update on Primary PCI 1009 Catheterization and Cardiovascular Interventions DOI 10.1002/ccd. Published on behalf of The Society for governed by the applicable Creative Commons License APPENDIX 1. 