Successful Thromboaspiration in STEMI Due to Extensive Coronary Thrombosis of Unclear Cause

New devices that allow continuous mechanical thromboaspiration are available.

A 59-year-old woman with no relevant medical history presented with anterior ST-segment elevation myocardial infarction and extensive thrombosis, with complete occlusion in the middle-third left anterior descending artery. Adequate establishment of coronary flow could not be achieved after multiple attempts with plain-old balloon angioplasty. Continuous mechanical thromboaspiration was then performed with a CAT RX aspiration system, obtaining normalization of distal coronary flow.

The routine use of thromboaspiration does not constitute the standard of endovascular management, but with a high thrombotic burden refractory to angioplasty, thromboaspiration represented the greatest clinical benefit, and after successful intervention, the patient's progress was satisfactory.

Patients with high myocardium mass at risk and notable thrombotic burden in whom conventional endovascular management has been ineffective may represent a subgroup of patients who can benefit the most from mechanical thromboaspiration. New devices that allow continuous thromboaspiration have been shown to be safe and effective, achieving very low or no residual thrombotic burden.