Khayyat Ibrahim, Nieto Diego Pineros, Bessisow Ali, Pelletier Jean-Philippe, Akl Elie
Division of Cardiology, McGill University, Montreal, Quebec, Canada.
Department of Radiology, McGill University, Montreal, Quebec, Canada.
JACC Case Rep. 2025 Aug 6;30(22):104628. doi: 10.1016/j.jaccas.2025.104628.
Significant thrombus burden can hinder successful reperfusion after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Thrombectomy devices may help reduce thrombus load, with recent advancements such as continuous vacuum aspiration now available through catheters connected to the Penumbra ENGINE.
We present the case of a 79-year-old woman with inferior ST-segment elevation myocardial infarction and significant thrombus burden in an ectatic right coronary artery, in which the use of 7-F Lightning 7 aspiration tubing (Penumbra) achieved effective clot retrieval and enabled successful percutaneous coronary intervention.
Lightning 7 aspiration tubing is not approved by the Food and Drug Administration for coronary intervention, making this, to our knowledge, the first reported case of successful coronary thrombus aspiration using a 7-F continuous aspiration catheter. Delivery to the distal right coronary artery required very supportive wires, and while the larger lumen enabled more effective thrombus removal, careful attention to blood loss is essential.
TAKE-HOME MESSAGE: Lightning 7 aspiration tubing may be safe and feasible to use in appropriately sized coronary arteries; however, distal vessel access is limited.
在ST段抬高型心肌梗死患者中，严重的血栓负荷会阻碍直接经皮冠状动脉介入治疗后的成功再灌注。血栓切除术装置可能有助于减少血栓负荷，目前有一些最新进展，例如现在可通过连接到Penumbra ENGINE的导管进行持续真空抽吸。
我们报告了一名79岁女性患者，患有下壁ST段抬高型心肌梗死，扩张的右冠状动脉内有严重血栓负荷，使用7F Lightning 7抽吸导管（Penumbra）成功实现了血栓清除，并使经皮冠状动脉介入治疗得以成功进行。
Lightning 7抽吸导管未获得美国食品药品监督管理局批准用于冠状动脉介入治疗，据我们所知，这是首例使用7F连续抽吸导管成功进行冠状动脉血栓抽吸的报道病例。将导管输送至右冠状动脉远端需要非常支撑性的导丝，虽然较大的管腔能更有效地清除血栓，但必须密切关注失血情况。
Lightning 7抽吸导管在适当大小的冠状动脉中使用可能是安全可行的；然而，远端血管通路有限。
