Coronary Interventional Devices: Balloon, Atherectomy, Thrombectomy and Distal Protection Devices

Samin K. Sharma, Victor Chen

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Percutaneous treatment of thrombus-containing lesions is associated with higher complication rates compared with nonthrombotic lesions. Adjunct devices, such as thrombectomy or distal protection, are commonly used as part of the interventional procedure along with the liberal use of GP IIb/IIIa inhibitors or vasodilators (Fig. 13). Percutaneous treatment of SVG using distal protection (PercuSurge or filter devices) is routinely recommended with stent implantation to improve short- and long-term results. Despite achieving TIMI-3 flow, myocardial perfusion in AMI remains suboptimal in a significant number of patients, resulting in larger final infarct size. Effective removal of thrombi before stenting theoretically may reduce distal embolization of thrombus, which could improve myocardial perfusion and salvage. Randomized studies do not support routine use of thrombectomy devices or distal protection devices with primary PCI in all patients who have AMI for the reduction of major adverse cardiac events. Simple manual aspiration with easy-to-use catheters to extract atherothrombotic material from target lesions, which restores flow and increases patency rate of an infarct-related artery before stenting, may be the hypothetical option for selected patients during primary PCI.

Original languageEnglish
Pages (from-to)201-215
Number of pages15
JournalCardiology Clinics
Volume24
Issue number2
DOIs
StatePublished - May 2006
Externally publishedYes

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