“…Although normal epicardial flow may be achieved, this will lead to diminished myocardial perfusion, which is associated with larger infarct size, diminished left ventricular ejection fraction and increased mortality [ 5 ]. Microvascular obstruction is frequently implicated as the underlying cause through the mechanism of embolization [ 6 – 8 ]. Distal protection devices (DPDs) can be used for transient distal balloon occlusion during PCI, and allow recovery of any liberated plaque by aspiration before restoration of the antegrade flow [ 9 ].…”