ABSTRACT
Embolic Protection with Proximal Occlusion Proximal occlusion devices cause blood flow stagnation by occluding the target coronary artery “upstream” from the lesion. With flow temporarily interrupted, thromboaspiration is performed and the stent or balloon is delivered to the lesion. Thromboaspiration is performed again and the proximal balloon is deflated, which restores blood flow. Advantages of proximal occlusion devices over distal occlusion or filters are several. First, proximal occlusions do not need to cross the lesion, thereby avoiding device-induced embolization. Second, device delivery is not affected as much by tortuous vessels. Third, the landing zone is always seen at the beginning of the procedure. Fourth, side branches are protected and humoral mediators theoretically do not reach the microcirculation. However, proximal occlusion devices may not have an adequate landing zone in ostial or proximal lesions.
