Key result
Percutaneous coronary intervention to the native proximal LAD in a patient with an occluded saphenous vein graft resulted in spontaneous late thrombolysis and patency of the graft at 3 months.
Case Report (n=1)
This case demonstrates a rare phenomenon of spontaneous late thrombolysis of an occluded saphenous vein graft alongside occlusion of the stented native LAD.
Should not change SVG management; hypothesis-generating for native PCI effects on late graft patency.
A 67-year-old male with prior history of myocardial infarction and coronary artery bypass grafting (individual vein grafts to the left anterior descending artery [LAD] and right coronary artery) presented with an acute anterior ST elevation myocardial infarction and cardiogenic shock. The vein graft to the LAD was occluded with heavy thrombus burden and there was severe native CAD. Given the degree of thrombus burden and other anatomic considerations, percutaneous intervention with stenting was performed to the native proximal LAD. Three months later, after complaining of atypical chest pain, repeat angiogram revealed a spontaneous widely patent vein graft to the LAD and occluded proximal LAD.
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SHAH et al. (2006) conducted a case report in Acute anterior ST elevation myocardial infarction and cardiogenic shock (n=1). Percutaneous coronary intervention with stenting to the native proximal LAD was evaluated on Angiographic findings at 3 months. Percutaneous coronary intervention to the native proximal LAD in a patient with an occluded saphenous vein graft resulted in spontaneous late thrombolysis and patency of the graft at 3 months.
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