The presence of thrombus is independently associated with adverse outcomes during percutaneous coronary intervention (PCI), particularly in those cases involving a large thrombus burden such as in saphenous vein grafts (SVGs) or during primary PCI. Mechanical thrombectomy devices are used to reduce the thrombus burden in such high-risk procedures to reduce the risk of distal embolization and slow flow and no-reflow. Here we describe 3 cases of successful use of a stent delivery system with a wide-bore lumen, the "five-in-six" Heartrail catheter, as a thrombectomy device in SVG lesions and primary PCI following failure of conventional simple aspiration thrombectomy catheters.