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Proximal embolic protection with aspiration in percutaneous coronary intervention using the Proxis device

Karel T Koch1, Joost D E Haeck, René J Van Der Schaaf

  • 1Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Reviews in Cardiovascular Medicine
|October 17, 2007
PubMed

Insights

Proximal embolic protection during primary percutaneous coronary intervention (PCI) effectively reduced distal embolization in ST-segment elevation myocardial infarction patients. This approach improved ST-segment elevation resolution and showed favorable 1-year outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Distal embolization during primary percutaneous coronary intervention (PCI) is common (≥15%) and linked to worse myocardial damage and prognosis.
  • Existing devices aim to clear thrombus or prevent distal embolization.
  • The Proxis device offers proximal embolic protection by blocking antegrade flow during PCI.

Purpose of the Study:

  • To evaluate the efficacy of the Proxis proximal embolic protection system during primary PCI for ST-segment elevation myocardial infarction.
  • To assess the impact of proximal embolic protection on ST-segment elevation resolution (STR) and clinical outcomes.

Main Methods:

  • A registry of 172 patients with ST-segment elevation myocardial infarction undergoing primary PCI was created.
  • Patients received proximal embolic protection using the Proxis device combined with aspiration.
  • ST-segment elevation resolution (STR) was measured at 1 hour post-procedure.

Main Results:

  • Mean STR at 1 hour was 77.7% ± 15.2%.
  • STR >50% was achieved in 94% of patients, and STR >70% in 72%.
  • The 1-year cumulative rate of major adverse cardiac and cerebrovascular events was 10.5%, with an overall mortality of 2.3%.

Conclusions:

  • Proximal embolic protection with the Proxis device is feasible and effective in primary PCI for STEMI.
  • This strategy leads to significant ST-segment elevation resolution.
  • The approach demonstrates promising safety and efficacy, with low 1-year adverse event rates.

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