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Intracoronary Thrombectomy Using an Off-Label 7-F Power Aspiration System for Inferior STEMI With Large Thrombus

Ibrahim Khayyat1, Diego Pineros Nieto2, Ali Bessisow2

  • 1Division of Cardiology, McGill University, Montreal, Quebec, Canada.

JACC. Case Reports
|August 8, 2025
PubMed

Insights

This study reports the first successful use of 7-F Lightning 7 aspiration tubing for coronary thrombus removal in ST-segment elevation myocardial infarction. The device effectively retrieved clot, enabling successful percutaneous coronary intervention.

Area of Science:

  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Significant thrombus burden complicates reperfusion in ST-elevation myocardial infarction (STEMI).
  • Thrombectomy devices aim to reduce thrombus load.
  • Continuous vacuum aspiration catheters represent an advancement in thrombectomy.

Observation:

  • A 79-year-old woman with inferior STEMI presented with a large thrombus burden in an ectatic right coronary artery.
  • The 7-F Lightning 7 aspiration tubing (Penumbra) was utilized for clot retrieval.
  • Effective clot retrieval was achieved, facilitating successful percutaneous coronary intervention.

Findings:

  • This case represents the first reported successful coronary thrombus aspiration using a 7-F continuous aspiration catheter.
  • The larger lumen of the Lightning 7 tubing facilitated effective thrombus removal.
  • Delivery to the distal right coronary artery required supportive wires.

Implications:

  • Lightning 7 aspiration tubing, though not FDA-approved for coronary use, demonstrates potential safety and feasibility.
  • Careful attention to blood loss is essential during aspiration.
  • Distal vessel access may be a limitation.
Abstract

Keywords:
intravascular ultrasoundpercutaneous coronary interventionthrombus

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