Key result
Percutaneous coronary intervention of a diffusely degenerated saphenous vein graft was successfully performed using ultra-thin sirolimus-eluting stents without an embolic protection device.
Why the study?
Saphenous vein grafts are vulnerable to degeneration and occlusion, but graft intervention for diffuse degeneration can potentially be performed without requiring a distal protection device.
Case Report (n=1)
No
PCI of a diffusely degenerated saphenous vein graft can be successfully performed using ultra-thin drug-eluting stents without an embolic protection device in complex clinical scenarios.
Hypothesis-generating for EPD-free PCI with ultra-thin DES in degenerated SVGs; prospective studies needed before adoption.
Years after coronary artery bypass graft surgery, plaque formation or graft degeneration is a major concern. Saphenous vein grafts (SVG) are vulnerable to degeneration and occlusion, leading to poorer long-term disease because of atherosclerotic degeneration. The main mechanism responsible for SVG failure is neointimal hyperplasia and the occluded SVG is treated with percutaneous coronary intervention, mostly with the use of additional protection devices. Graft intervention for the diffuse degeneration of SVG can be performed with the use of suitable hardware without the distal protection device being required. The authors herein report the case of a 63-year-old female who presented with degenerated SVG to the left anterior descending artery with anastomotic stenosis, 6 years after coronary artery bypass graft surgery. She was successfully treated with three ultra-thin sirolimus-eluting stents in SVG to the left anterior descending artery, without the use of any embolic protection device.
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Jariwala et al. (2020) conducted a case report in Diffusely degenerated saphenous vein graft (n=1). Percutaneous coronary intervention with ultra-thin sirolimus-eluting stents was evaluated on Procedural success and clinical stability. Percutaneous coronary intervention of a diffusely degenerated saphenous vein graft was successfully performed using ultra-thin sirolimus-eluting stents without an embolic protection device.
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