Key result
Repeat angiography with careful catheter positioning demonstrated that apparent progression of proximal stenosis to total occlusion after bypass grafting was an artifact of competitive blood flow.
Case Report (n=1)
Competitive blood flow from saphenous vein grafts can simulate progression of native proximal coronary disease on angiography, which can be clarified with careful catheter positioning and contrast injection.
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Apparent post-bypass proximal occlusion may reflect competitive flow artifact; challenges consensus on native disease progression and leaves open validation in larger cohorts.
Miller et al. (1984) conducted a case report in Coronary artery disease after saphenous vein bypass surgery (n=1). Repeat angiography with careful catheter positioning and adequate contrast injection vs. Initial coronary angiography was evaluated on Demonstration of actual anatomy and postoperative change in native coronary circulation. Repeat angiography with careful catheter positioning demonstrated that apparent progression of proximal stenosis to total occlusion after bypass grafting was an artifact of competitive blood flow.
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