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Despite the low injury of endovascular interventions, there are a number of complications that significantly worsen the prognosis of patients. The most unfavorable complications in patients with ST-segment elevation myocardial infarction during primary percutaneous coronary intervention are stent thrombosis, coronary artery perforation, tamponade, complications at the arterial access site, distal embolism, development of the "no-reflow", stroke. The article is devoted to the study of the frequency of these complications in primary percutaneous coronary intervention in combination with manual thromboaspiration.