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Case Report Open Access
A 57-year-old man was hospitalized with chest pain of 1-h duration. Emergency coronary angiography revealed a total occlusion of a non-collateralized distal (segment 3) right coronary artery by a large thrombus. Multiple aspiration thrombectomies of the segment 3 lesion were performed, after which the thrombus migrated inside the guiding catheter. To prevent systemic embolization at the time of extraction, a double guiding procedure was performed to ensure that no thrombus was protruding from the tip of the catheter. The guiding catheter and a large red thrombus were ultimately safely extracted, while maintaining negative pressure in the catheter lumen with a syringe. The patient was discharged from the hospital on the 14th day free from chest pain. The histopathology of the aspirated thrombus was consistent with a coronary arterial embolization. This case indicates that, in patients with acute MI, aspiration thrombectomy performed for the prevention of thrombotic embolization can be safe and effective.
Aspiration thrombectomy, Systemic embolization, Coronary embolism, Medical Case Reports