Percutaneous coronary interventions (PCI) of thrombus-containing lesions are associated with increased risk of complications such as distal coronary embolisation and impaired coronary circulation. Although the use of thrombectomy devices to aspirate thrombus during primary PCI is currently not routinely recommended, there is growing evidence suggesting the use of thrombus aspiration catheters during PCI. Here, we report the case of a 70 year-old patient undergoing thrombus aspiration therapy because of the development of coronary bifurcation macroemboli during initial phase of primary PCI. After successful thrombus aspiration therapy, dramatic improvements in both coronary flow and ST-segment resolution were achieved.