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 r emain among the major limitations of percutaneous transluminal coronary int erventions. We describe three cases in which intragraft or intracoronary th rombus 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 resto ration of normal flow. In the second case, multiple fragments of embolized thrombus were aspirated from a large right coronary artery, while in the th ird case, intragraft thrombus was electively aspirated. In each case, the i ndex lesions were then successfully stented without complications. (C) 2000 Wiley-Liss, Inc.