We describe a case of 61 year-old man with acute myocardial infarction (AMI) and with large thrombus in right coronary artery. The patient underwent primary angioplasty with complex embolic protection: pharmacological, thromboaspiration and filter protection device. This triple embolic protection was necessary to evacuate thrombi and successfully restore normal flow in coronary artery. Despite distal protection has no evidence to be beneficial in AMI, the use of filter protection might be considered in selected patients.