In acute myocardial infarction (AMI), slow flow (<TIMI 3) after reperfusion remains a problem. Removing the thrombus from culprit lesions should reduce this phenomenon and improve clinical outcome, so to evaluate the advantages of the Rescue percutaneous thrombectomy system (Rescue PT), 65 cases of AMI in which Rescue PT (RT group) was carried out were compared with 66 cases of AMI that were treated before Rescue PT became available (non-RT group). The study compared angiographic results, in-hospital clinical outcomes and the cost estimation during hospitalization. In the RT group, direct stenting was chosen more frequently (57% vs 5%, p=0.002) and the number of balloon catheters used was less (0.7±0.8 vs 1.4±0.6, p<0.0001). The incidence of slow flow and the maximum serum creatine kinase value over 24 h were lower in the RT group (3.1% vs 19.7%, p=0.01 and 3,444±2,218 IU vs 4,182±3,010 IU, p<0.05 respectively); however, in-hospital clinical outcomes were identical. No major complication related to the Rescue PT procedure was found. The cost for the initial procedure and the total cost during hospitalization were similar between the groups. Thrombectomy with Rescue PT before mechanical dilatation of the culprit lesions is safe and feasible, even in the emergency clinical setting, and results in better angiographic coronary flow. This therapy facilitates direct stenting and does not increase the cost of treatment. (Circ J 2003; 67: 768 - 774)