Two drugs have emerged in particular as possible adjunct to reperfusion therapy: nitroprusside and adenosine. For the former good results have been obtained in small series, in contrast adenosine has been tested in a large randomized trial (AMISTAD-II trial) with controversial results when used at low dose. Another study using larger doses and a sub-analysis of a high dose group of the AMISTAD-II trial suggested a beneficial effect on infarct size. Importantly, none of this studies have been performed in the setting of thrombus aspiration.