Nowadays primary PCI (Percutaneous Coronary Intervention) is the treatment of choice for ST Elevation Myocardial Infarction and has absolute advantage to classic thrombolytic drug therapy. But primary PCI itself has an important drawback that is “no reflow phenomenon”. In recent years several medical and mechanical solutions have introduced to overcome this problem. Gradually manual thrombus suction established as an effective mechanical and safe method. In this report we present the first patient who treated by primary PCI and manual thrombus suction in Zanjan province with completely successful results.