Cheema, M.D., Ph.D., Robert C. Welsh, M.D., Olivier F. Bertrand, M.D., Ph.D., Alvaro Avezum, M.D., Ph.D., Ravinay Bhindi, M.B.B.S., Ph.D., Samir Pancholy, M.D., Sunil V. Rao, M.D., Madhu K. Natarajan, M.D. Ten Berg, M.D., Ph.D., Olga Shestakovska, M.Sc., Peggy Gao, M.Sc., Petr Widimsky, M.D., D.Sc.D. For the TOTAL Investigators: Randomized Trial of Principal PCI with or without Routine Manual Thrombectomy Main percutaneous coronary intervention , when available, is the most effective method of achieving reperfusion in individuals with ST-segment elevation myocardial infarction .1 However, a major limitation of main PCI is the chance for distal embolization of thrombus and failure to restore flow at the microvascular level.The problem, then, is among attachment or habit. If you grew up with a whole lot of uncertainty or psychological trauma, or under the guidance of a worrier, then you developed a familiarity with or attachment to the feeling of being uncontrollable that goes with chronic worry. These attachments can sabotage our internal peace because we live as though the state of worry is ‘house’ and can’t imagine life outside of it. Raising your awareness around the issue is essential to overcoming it.