We present a case in which, after performing an optimal angioplasty after an acute myocardial infarction with intracoronary thrombus, normal coronary flow was not achieved. After aspirating through the guiding catheter we obtained a large thrombus that the histopathologic study confirmed as a recent thrombus and, subsequently, normal flow was reestablished. The procedure was completed with a successful intracoronary stent implantation, with an uneventful clinical course. The therapeutic and diagnostic implications of this case are discussed.