Published reports demonstrate improved myocardial reperfusion with adjunctive thrombus aspiration in ST-elevation myocardial infarction (STEMI). However, implementation of this procedure without angioplasty or stent implantation is not clear. In this report, we present an octogenarian with inferior STEMI who was treated with thrombus aspiration alone. Another important feature of our case is trapped thrombus material in the guiding catheter during thrombus aspiration. Operators should avoid thrombus re-injection by controlling the system carefully during aspiration procedure.