Distal Myocardial Protection During Percutaneous Coronary Intervention
When and Where?
Diana A. Gorog, MD, PhD, MRCP*,
Rodney A. Foale, MD, FRCP and
Iqbal Malik, PhD, MRCP
Waller Cardiac Department, St. Mary’s Hospital, London, United Kingdom
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Figure 1 The FilterWire system. (Panel 1) The polyurethane porous membrane filter attached to a nitinol loop. (Panel 2) The filter is deployed distal to the lesion, and the nitinol loop self-expands to fit the vessel upon retraction of the delivery sheath. (Panel 3) Saphenous vein graft containing thrombus, seen as intraluminal filling defect (A), treated with percutaneous coronary intervention using FilterWire protection (B), achieving a good result after stenting (C).
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Figure 2 The GuardWire system. Upper panel corresponds to lower panel: the GuardWire, used to cross the lesion, is inserted into the MicroSeal Adapter (A), connected to the EZ Flator, which is inflated to occlude the vessel (B). Debris is aspirated using the Export Aspiration catheter (C). SVG = saphenous vein graft.
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Figure 3 The Proxis system is delivered through a guiding catheter, and the sealing balloon (A) is inflated proximal to the stenosis, arresting flow, and debris aspirated through the Proxis system (B).
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Figure 4 The X-Sizer thrombectomy system comes ready to assemble in a tray (panel 1). Schematic of mechanism of action (panel 2). Panel 3 shows angiogram of right coronary artery proximally occluded by thrombus (A), X-sizer thrombectomy device in situ (B), and angiographic appearance after thrombectomy (C).
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