Coronary interventional devices: balloon, atherectomy, thrombectomy and distal protection devices.

With increased operator experience and improved device technology, there has been a constant growth in the number of complex lesions (ie, thrombotic lesions, diffuse lesions,calcified lesions, nondilatable rigid lesions, ostial lesions, bifurcations, and chronic total occlusions) attempted by interventionalists with the use of drug-eluting stents. Although coronary stent implantation remains the mainstay and ultimate step for the treatment of most coronary lesions, adjunctive devices may be essential for lesion preparation in some cases (5%-10%) to allow stent deployment and expansion and prevent distal embolization. Thrombectomy and distal protection devices have shown to be effective in the interventions of saphenous vein graft lesions, although their use remains unproven in acute myocardial infarctions.