CORONARY INTERVENTIONS 689 CLINICAL RESEARCH EuroIntervention 2014;10:689-693 DOI: 10.4244/EIJV10I6A120 © Europa Digital & Publishing 2014. All rights reserved. *Corresponding author: Manchester Heart Centre, Manchester Royal Infirmary, Manchester, M13 9WL, United Kingdom. E-mail: samer_arnous@yahoo.com Thrombus capture by withdrawal of an open filter device: a useful treatment for large non-occlusive coronary thrombus Samer Arnous 1 *, MB, BCh, MRCPI; Maria Agelaki 1 , MD, PhD; Nizar Shakhshir 1 , MD, MRCP; Damien Kelly, MB BCh; Farzin Fath Ordoubadi 1 , BM, BChir, MD; Mamas A. Mamas 1,2 , BM, BCh, DPhil, MRCP; Douglas Fraser 1 , MB, BChir, DM 1. Manchester Heart Centre, Manchester Royal Infirmary, Biomedical Research Centre, Manchester, United Kingdom; 2. Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom Abstract Aims: The aim of this study was to assess the safety and feasibility of manual removal of a non-occlusive coronary thrombus using an open filter device. Methods and results: Between April 2006 and December 2011, 1,102 patients were treated percutane- ously for acute coronary syndrome at our institution. Of these, nine (1%) had a large “cannon-ball” non- occlusive intracoronary thrombus, which did not improve with standard thrombectomy aspiration catheters. In these patients, we describe a novel technique of thrombus removal using the ev3 Spider™ filter device. Four patients had LAD thrombus, three had RCA thrombus, one LCX thrombus and one SVG thrombus. The primary endpoint of substantial or complete thrombus removal, prevention of no-reflow/slow flow phenom- enon and achievement of TIMI 3 flow post stenting was achieved in all cases. Coronary dissection occurred in one case where the lesion was heavily calcified. There were no other complications related to the device. Conclusions: This is the first case series describing the use of the ev3 Spider™ filter device for the removal of a large intracoronary thrombus refractory to conventional treatment. This was associated with a high pro- cedural success rate and may reduce the risk of no-reflow in these cases. KEYWORDS • coronary artery disease • coronary flow • non-ST-elevation myocardial infarction • ST-elevation myocardial infarction • thrombus removal SUBMITTED ON 23/02/2013 - REVISION RECEIVED ON 1 st 25/07/2013 / 2 nd 08/08/2013 - ACCEPTED ON 13/08/2013