title: Cases report: Experience with rheolytic thrombectomy device (Angiojet) in acute ST elevation myocardial infarction with large amount of coronary thrombus.
abstract: BACKGROUND
  Primary percutaneous coronary intervention (PCI) in acute ST elevation myocardial infarction (STEMI) is a clinical challenge. Adequate thrombus removal before stenting is an important factor that predicts procedural success, and finally reflects to clinical outcomes.
  
  
  METHODS
  In the present report, 2 cases of acute STEMI underwent primary PCI. Coronary angiogram (CAG) in both cases showed a large amount of coronary thrombus (TIMI thrombus grade 4 & grade 5), with no response to several attempts of manual aspiration with thrombus aspiration catheter Then, Angiojet rheolytic thrombectomy, a catheter-based, device was used antegradely. Repeated CA G showed thrombus was significantly eliminated. Both patients were successfully stented with direct stent technique at culprit arteries, resulted in good angiographic results and inhospital outcomes.
  
  
  CONCLUSIONS
  Angiojet, a rheolytic thrombectomy device, is a viable option to remove thrombus in primary PCI, especially in cases with massive thrombus load and failed manual aspiration.
authors.affiliation: Cardiology & Intervention Department, Central Chest Institute, Nonthaburi, Thailand. dansuwan_t@yahoo.co.th
authors.forename: Thamarath
authors.initials: T
authors.lastname: Chantadansuwan
authors.forename: Wirash
authors.initials: W
authors.lastname: Kehasukcharoen
authors.forename: Kriengkrai
authors.initials: K
authors.lastname: Hengrussamee
mesh_terms: D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D003328:Coronary Thrombosis / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery*; D004562:Electrocardiography / Q000379:methods; D004867:Equipment Design; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D017131:Thrombectomy / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome; D062666:Vascular Access Devices