<International Circulation>:   You have said that in many STEMIs， the rule is that you go for the culprit lesion; you don’t concentrate on any other occlusions. Does that apply also in shock cases?

　　《国际循环》：您说过对很多STEMI的患者，您的原则是主要处理罪犯血管，您并不太关注除罪犯血管外其他的血管闭塞。这个原则是否也同样适用于休克病例呢？

　　Dr Mehta:  In patients having an acute MI which is complicated by cardiogenic shock， you probably need to recanalize a much larger distribution of ischemic territory. Cardiogenic shock is one of those rare exceptions in STEMI intervention where you go only for the culprit lesion and there is a fair amount of data that demonstrates that. In some of these cases you can also proceed to taking care of non-culprit vessels after the culprit vessel has been addressed. The first effort has to be on the culprit and then the non-culprit if they are located in areas proximal to large vessels. The patient with a STEMI intervention gets only sicker lying on the table and it should not be lesions that are technically very difficult that will consume a lot of dye， radio contrast agent or time. On the other hand if it is something relatively straight-forward in a large segment of a vessel， if you are able to reanalyze that in addition to the culprit lesion， the patient generally will have a better outcome where they are in cardiogenic shock.