{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:01:54Z","timestamp":1780095714559,"version":"3.54.0"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mechanical thrombectomy (mTE) is an established standard of care for selected patients with acute ischaemic stroke. However, in the cardiac equivalent\u2014acute coronary syndrome\u2014current guidelines do not recommend mTE. This is primarily based on trials showing no mortality benefit from routine thrombus aspiration, along with an increased risk of stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 76-year-old male with known three-vessel coronary artery disease and a history of coronary artery bypass grafting presented to our emergency department with a non-ST-elevation myocardial infarction. Angiography revealed a subacute occlusion of the saphenous vein graft to the posterior descending artery. An initial attempt at percutaneous coronary intervention of the native right coronary artery was unsuccessful due to severe calcification. Following successful recanalization of the vein graft, a high thrombus burden persisted despite manual aspiration and tirofiban bolus with continuous infusion, as confirmed by repeat angiography at the next day. Consequently, we performed mTE using a stent retriever system, achieving complete thrombus removal. This was followed by stent implantation in the vein graft, with final angiography demonstrating full restoration of distal perfusion. This case highlights the value of mTE as a bailout strategy in cases with a substantial thrombus burden, particularly in vein grafts, and underscores the potential of a stepwise approach starting with aspiration and escalating to mTE if required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case illustrates that in selected cases of myocardial infarction with a substantial thrombus burden, mTE may help achieve TIMI-III flow and reduce the risk of distal embolization. Moreover, it demonstrates the feasibility of delivering a stent retriever through an aspiration catheter, thereby enabling a less invasive, resource-efficient, and potentially safer procedural strategy without the need for a dedicated microcatheter.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag170","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T12:36:24Z","timestamp":1773146184000},"source":"Crossref","is-referenced-by-count":1,"title":["Successful mechanical thrombectomy of a large venous graft thrombus burden using a novel device in an unusual way: a case report"],"prefix":"10.1093","volume":"10","author":[{"given":"Nikolaus","family":"L\u00f6ffelhardt","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg , S\u00fcdring 15, Bad Krozingen 79189 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Marc","family":"Valina","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg , S\u00fcdring 15, Bad Krozingen 79189 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kille","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg , S\u00fcdring 15, Bad Krozingen 79189 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7542-1956","authenticated-orcid":false,"given":"Dirk","family":"Westermann","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg , S\u00fcdring 15, Bad Krozingen 79189 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7390-5287","authenticated-orcid":false,"given":"Philipp","family":"Breitbart","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg , S\u00fcdring 15, Bad Krozingen 79189 ,","place":["Germany"]},{"name":"Cardioangiological Center Bethanien (CCB) , Im Pr\u00fcfling 23, Frankfurt 60389 ,","place":["Germany"]},{"name":"AGAPLESION Bethanien Hospital , Im Pr\u00fcfling 21-25, Frankfurt 60389 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"2026041704170414700_ytag170-B1","doi-asserted-by":"crossref","first-page":"3020","DOI":"10.1161\/STR.0000000000000074","article-title":"2015 American Heart Association\/American stroke association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association\/American stroke association","volume":"46","author":"Powers","year":"2015","journal-title":"Stroke"},{"key":"2026041704170414700_ytag170-B2","doi-asserted-by":"crossref","first-page":"e366","DOI":"10.1016\/j.wneu.2023.12.101","article-title":"Aspiration thrombectomy versus stent-retriever thrombectomy for the first-pass therapy of intracranial atherosclerosis-related large vessel occlusion: a post hoc analysis of the endovascular treatment with versus without tirofiban for patients with large vessel occlusion stroke trial","volume":"183","author":"Huang","year":"2024","journal-title":"World Neurosurg"},{"key":"2026041704170414700_ytag170-B3","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/S0140-6736(15)00448-1","article-title":"Outcomes after thrombus aspiration for ST elevation myocardial infarction: 1-year follow-up of the prospective randomised TOTAL trial","volume":"387","author":"Jolly","year":"2016","journal-title":"Lancet"},{"key":"2026041704170414700_ytag170-B4","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1056\/NEJMoa1405707","article-title":"Outcomes 1 year after thrombus aspiration for myocardial infarction","volume":"371","author":"Lagerqvist","year":"2014","journal-title":"N Engl J Med"},{"key":"2026041704170414700_ytag170-B5","doi-asserted-by":"crossref","first-page":"2550","DOI":"10.1161\/01.CIR.103.21.2550","article-title":"Combination therapy with abciximab reduces angiographically evident thrombus in acute myocardial infarction: a TIMI 14 substudy","volume":"103","author":"Gibson","year":"2001","journal-title":"Circulation"}],"container-title":["European Heart Journal - 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