Incidence of Complications and Related Problems with Embolic Protection Devices Usage: Technical Characteristics of the Proxis™ System 

Embolization of atherothrombotic debris during PCI, resulting in microcirculatory dysfunction, has been suggested as responsible for lack of myocardial reperfusion and increased necrosis leading to left ventricular dysfunction, particularly in the setting of degenerated saphenous vein graft (SVG) stenting. However, recent studies provided evidence that distal embolization also occurs during PCI on native coronary arteries. The risk of “no reflow” has been reported in up to 30% of cases during treatment of thrombotic lesions after PCI of SVG and in up to 15% of cases during PCI of native coronary artery. Several pharmacological approaches, with administration of thrombolytics, adenosine or antiplatelet agent, likewise mechanical technique including direct stenting, extraction coronary atherectomy, directional coronary atherectomy, laser angioplasty and ultrasound thrombolysis failed to achieve a significant reduction in distal embolization and its complications. Different distal protection devices have been developed to trap plaque-derived emboli during PCI and prevent distal embolization. Such devices can be classified as distally occlusive, proximally occlusive and distal filtering (table 1) and have been employed in different vascular...continua a leggere