Guiding catheter thrombectomy during percutaneous coronary interventions for acute coronary syndromes

Despite the advancements in the pharmacological and mechanical treatment of acute coronary syndromes, intracoronary thrombus and distal embolization remain among the major limitations of percutaneous transluminal coronary interventions. We describe three cases in which intragraft or intracoronary thrombus was completely aspirated during PTCI using the guiding catheter. In the first case, a 4-cm-long unfragmented embolized thrombus was effectively and completely aspirated from a saphenous vein graft, with immediate restoration of normal flow. In the second case, multiple fragments of embolized thrombus were aspirated from a large right coronary artery, while in the third case, intragraft thrombus was electively aspirated. In each case, the index lesions were then successfully stented without complications. (C) 2000 Wiley-Liss, Inc.