Embolic Protection Devices in Saphenous Vein Graft and Native Vessel Percutaneous Intervention: A Review

The clinical benefit of percutaneous intervention (PCI) depends on both angiographic success at the site of interventionas well as the restoration of adequate microvascular perfusion. Saphenous vein graft intervention is commonlyassociated with evidence of distal plaque embolization, which is correlated with worse clinical outcomes. Despite successfulepicardial intervention in the acute MI patient treated with primary PCI, distal tissue perfusion may still be absent inup to 25% of cases [1-3]. Multiple devices and pharmacologic regimens have been developed and refined in an attempt toprotect the microvascular circulation during both saphenous vein graft intervention and primary PCI in the acute MI setting.We will review the evidence for various techniques for embolic protection of the distal myocardium during saphenousvein graft PCI and primary PCI in the native vessel.