{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T21:43:03Z","timestamp":1784238183020,"version":"3.55.0"},"reference-count":9,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,4,21]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2022-251129","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T10:52:05Z","timestamp":1683543125000},"page":"e251129","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Aspiration thrombectomy: safe removal of thrombi too big to aspirate"],"prefix":"10.1136","volume":"16","author":[{"given":"Lucas","family":"Chacon","sequence":"first","affiliation":[{"name":"Cardiology, University of New Mexico Health Sciences, Albuquerque, New Mexico, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Sheldon","sequence":"additional","affiliation":[{"name":"Cardiology, University of New Mexico Health Sciences, Albuquerque, New Mexico, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanawan","family":"Riangwiwat","sequence":"additional","affiliation":[{"name":"Cardiology, Geisinger Health System, Danville, Quebec, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Blankenship","sequence":"additional","affiliation":[{"name":"Cardiology, University of New Mexico Health Sciences, Albuquerque, New Mexico, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,5,8]]},"reference":[{"key":"2025082703501890000_16.5.e251129.1","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.jacc.2021.09.005","article-title":"2021 ACC\/AHA\/SCAI guideline for coronary artery revascularization: Executive summary: a report of the American College of cardiology\/american heart association joint Committee on clinical practice guidelines","volume":"79","author":"Lawton","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2025082703501890000_16.5.e251129.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1415098"},{"key":"2025082703501890000_16.5.e251129.3","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/j.jaccas.2020.05.007","article-title":"A mechanism for stroke complicating coronary thrombus aspiration","volume":"2","author":"Riangwiwat","year":"2020","journal-title":"JACC Case Rep"},{"key":"2025082703501890000_16.5.e251129.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60833-8"},{"key":"2025082703501890000_16.5.e251129.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.04.025"},{"key":"2025082703501890000_16.5.e251129.6","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1111\/joic.12249","article-title":"Aspiration thrombectomy in patients undergoing primary angioplasty for ST elevation myocardial infarction: an updated meta-analysis","volume":"28","author":"Ghatak","year":"2015","journal-title":"J Interv Cardiol"},{"key":"2025082703501890000_16.5.e251129.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.10.005"},{"key":"2025082703501890000_16.5.e251129.8","unstructured":"Mathews SJ . CHEETAH: a prospective, multicenter study to evaluate the safety and performance of the CAT RX aspiration catheter in patients with a high thrombus burden acute coronary vessel occlusion. (August 22 2019 \u2013 June 2 2021). NCT03957473 . 2021 Available: https:\/\/clinicaltrials.gov\/ct2\/show\/study\/NCT03957473"},{"key":"2025082703501890000_16.5.e251129.9","first-page":"70","article-title":"The first reported aspiration thrombectomy with a guide extension mother-and-child catheter in ST elevation myocardial infarction due to bacterial vegetation coronary artery embolism","volume":"12","author":"Ciecwierz","year":"2016","journal-title":"Postepy Kardiol Interwencyjnej"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-251129","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:50:23Z","timestamp":1756291823000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-251129"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":9,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5,8]]},"published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1136\/bcr-2022-251129"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-251129","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]}}}