The distal embolic protection failed to demonstrate clear advantages during PCI. 

Primary percutaneous coronary intervention (PCI) has been shown to be superior to thrombolytic therapy in treatment of ST-segment elevation myocardial infarction (STEMI) in patients admitted to high volume angioplasty centers. Primary PCI reduces major adverse cardiac events, including death and non fatal myocardial reinfarction as compared to thrombolytic therapy, irrespective of the type of thrombolytic regimen used. Primary PCI aims at early and sustained restoration of flow in the infarct related coronary artery in order to reperfuse the myocardium at tissue level. However, distal embolization may occur during recanalization of thrombotic coronary occlusion, leading to less optimal angiographic results during PCI. Angiographic evidence of distal embolization, either before or after primary PCI is associated with reduced epicardial and myocardial perfusion. Distal embolization during primary PCI occurs in at least 15% of patients and is a strong predictor of more extensive myocardial damage and a poor prognosis. Recent trials of the use of distal embolic protection and thrombectomy devices during primary PCI have demonstrated mostly neutral or even negative effects on myocardial reperfusion, infarct size or clinical outcome. These trials evaluated different devices with different structure and operational mechanisms: the effects of...continua a leggere