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Aspiration thrombectomy: safe removal of thrombi too big to aspirate
  1. Lucas Chacon1,
  2. Mark Sheldon1,
  3. Tanawan Riangwiwat2 and
  4. James Blankenship1
  1. 1Cardiology, University of New Mexico Health Sciences, Albuquerque, New Mexico, USA
  2. 2Cardiology, Geisinger Health System, Danville, Quebec, USA
  1. Correspondence to Dr Mark Sheldon; masheldon{at}


Aspiration thrombectomy has been associated with an increased risk of stroke, and its routine use is not recommended. Ill-defined procedural techniques for aspiration thrombectomy may provide an explanation for inconsistent outcomes and adverse event rates in trials. Large thrombi can plug the aspiration port of the aspiration catheter and then be dislodged into the central circulation when they are retracted into the guide catheter, or when the aspiration catheter is removed from the Tuohy connector. We report a case of thrombus aspiration where a large distal thrombus was aspirated into the mouth of the aspiration catheter, held there with suction as it was removed and delivered outside the body without being dislodged. We offer several tips for safe removal of coronary thrombi too big to aspirate.

  • Cardiovascular medicine
  • Interventional cardiology
  • Ischaemic heart disease

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  • Twitter @LchaconMD, @Tanawan_Mai

  • Contributors The patient was cared for by JB and LC. JB provided guidance for this submission. Review of prior cases was provided by TR. The manuscript was written by LC. Final review was performed by MS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.