Thrombus aspiration alone: a potential strategy in ST elevation myocardial infarction intervention

We are reporting a case of 46 year-old man, smoker with strong family history of coronary artery disease, presenting with acute anterolateral ST elevation myocardial infarction (STEMI). Diagnostic angiography revealed thrombus at the distal left main, occluding the anterior descending and intermediate arteries. Thrombus aspiration was performed with successful return of flow in the left coronary system. Stenting was deferred due to absence of occlusive lesion. He was commenced on glycoprotein (GP) IIbIIIa inhibitor and received intra-aortic balloon pulsation for haemodynamic support. Follow-up angiography revealed good flow in left coronary artery with normal ventricular function and no significant disease. He remained event-free at one-year follow-up. This case demonstrated that in the absence of occlusive lesion, thrombus aspiration alone without angioplasty or stenting is safe and effective with good clinical outcome.