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Only few randomized trials have been conducted to evaluate the optimal arterial access choice, antithrombotic therapy, stent type, or the role of aspiration thrombectomy in this population. Observational data suggest that a transradial approach should be preferred for experienced operators, although knowledge and experience of transfemoral access is required to place any mechanical support device. In the absence of high\u2010quality evidence to guide choice of the adjunctive antithrombotic drugs to support PCI in patients with AMICS, knowledge of the altered pharmacokinetics and pharmacodynamics in shock is required to inform decisions. Drug\u2010eluting stents should be favored over bare\u2010metal stents, and routine thrombectomy is not encouraged. Owing to the challenges inherent to the conduct of randomized trials in this acutely ill patient population, concerted multicenter, and international efforts are paramount to orchestrate the development of high\u2010quality evidence to guide clinical practice.<\/jats:p>","DOI":"10.1002\/ccd.28455","type":"journal-article","created":{"date-parts":[[2019,8,22]],"date-time":"2019-08-22T06:18:42Z","timestamp":1566454722000},"page":"924-931","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Technical consideration in acute myocardial infarction with cardiogenic shock: A review of antithrombotic and PCI therapies"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2965-1504","authenticated-orcid":false,"given":"Guillaume","family":"Marquis\u2010Gravel","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina"},{"name":"Division of Cardiology Duke University Medical Center  Duke Heart Center, Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Zeitouni","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajar","family":"Kochar","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute  Durham North Carolina"},{"name":"Division of Cardiology Duke University Medical Center  Duke Heart Center, Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. 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