A massive intracoronary thrombus, during percutaneous coronary intervention (PCI), implies a high risk of major adverse cardiac events. We experienced a case of successful PCI, using Percusurge(r), in an acute myocardial infarc-tion patient, with massive intracoronary thrombi. The TIMI 3 coronary flow could not be restored during a primary PCI of the right coronary artery, despite repeated ballooning, intracoronary urokinase injection, parenteral abciximab and heparin. However, successful PCI, with stenting, was performed by aspiration of the large intracoronary thrombi, with the Percusurge(r) system, 5 days after the primacy PCI.