ABSTRACT
This chapter describes several aspects related to the biological components of the atherosclerotic plaque and the rationale, clinical evidence, and indications for different interventional devices. It explains the devices that prepare very hard atherosclerotic plaques prior to stenting, for example, rotational atherectomy, to devices that are either used to remove very soft, friable, or thrombotic lesions, such as thrombectomy, or those preventing distal embolization during intervention by temporary vessel occlusion or filter placement. Thromboaspiration devices are used to remove thrombus from the coronary lesions during primary percutaneous coronary intervention (PCI) in order to reduce distal embolization. The distal embolic protection system is based on transient distal balloon occlusion coupled with an aspiration catheter to prevent plaque debris embolization. Although there is an ample heterogeneity in designs, aspiration capacity, and operational principles, thrombectomy devices can be further divided into manual and mechanical.
