Distal embolization is very important periprocedural problem during percutaneous coronary interention (PCI) in ST segment elevation myocardial infarction (STEMI). The doctoral dissertation presents an analysis of groups of patients who can particularly benefit from the use of manuał thrombectomy in STEMI. The study gro up consisted of 100 patients with S TEMI treated with primary PCI and aspiration thrombectomy with or without balloon predilation with stent implantation to infarct related artery (IRA). The clinical results of patients treated with thrombectomy were more favorable in the non-diabetic group and in clinical stable patients Similarly, better effect of the treatment was observed in population of younger, no-reflow and mortality were less common in this group. There was no impact of multivessel disease, gender or segment of the IRA on clinical results. The thrombus grade 5 category has been shown to be an independent predictor for TIMI 3 flow and małe gender for MBG 3 flow after PCI with thrombectomy. There were no independent predictors for mortality or clinical endpoints. A more favorable angiographic result was observed m the group of thrombectomy without balloon predilatation. Complications after the procedure, including the transient no-reflow syndrome and bail-out use of GP Ilb / IIIa inhibitors were more frequently observed in the thrombectomy with predilatation group. In addition, there was a trend for more frequent A-type dissection and recurrent coronary ischemia during 24 hours from PCI in this group of patients. Recurrent PCI, mainly in IRA, occurred more frequently in the thrombectomy with predilatation group. However, there was difference in short- and long-term mortality between analyzed groups. The results of the study suggest that there are subgroups of patients who benefit more from primary PCI in STEMI with manuał aspiration thrombectomy.