The clinical benefit of percutaneous intervention (PCI) depends on both angiographic success at the site of intervention
as well as the restoration of adequate microvascular perfusion. Saphenous vein graft intervention is commonly
associated with evidence of distal plaque embolization, which is correlated with worse clinical outcomes. Despite successful
epicardial intervention in the acute MI patient treated with primary PCI, distal tissue perfusion may still be absent in
up to 25% of cases [1-3]. Multiple devices and pharmacologic regimens have been developed and refined in an attempt to
protect 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 saphenous
vein graft PCI and primary PCI in the native vessel.
Keywords: Embolic protection devices, microvascular obstruction, no-reflow, plaque embolization, saphenous vein grafts,
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