ON THE COVER A 57-year-old man with a history of coronary artery disease was admitted presenting with anterior ST-segment elevation myocardial infarction and cardiogenic shock. Cardiac catheterization revealed total occlusion in the proximal portion of a left anterior descending artery (LAD) (A). After crossing the occlusion with a balloon catheter without dilation, a large thrombus with significant narrowing became evident (B). Thrombus aspiration with a thrombectomy device (Diver CE, Invatec s.r.l., Roncadelle, Italy) resulted in Thrombolysis In Myocardial Infarction (TIMI) flow grade 3, instant restoration of normal blood pressure, ST-segment resolution, and chest pain release. A lesion was treated by stent implantation in the proximal portion of the LAD, with good angiographic results (C). A postprocedure analysis of aspirated material revealed a giant thrombus that was 24-mm long (D). Images provided by Marcin Sadowski, MD, Marianna Janion, MD, PhD, from Świętokrzyskie Centrum Kardiologii, Kielce, Poland.