Key result
A saphenous vein graft perforation during percutaneous coronary intervention was successfully managed with a covered stent, resulting in complete sealing and an asymptomatic patient at 1 month.
Case Report (n=1)
No
Saphenous vein graft perforation during PCI is a rare but catastrophic complication that requires immediate management including prolonged balloon occlusion, reversal of anticoagulation, and covered stents.
Adds to sparse reports on covered stents for SVG perforation; leaves open need for controlled studies.
Percutaneous coronary interventions (PCIs) of saphenous vein grafts (SVGs) is challenging and is associated with adverse short- and long-term clinical outcome as compared to native coronary arteries. SVG perforation is rare but catastrophic and needs immediate attention. Various factors predisposing for SVG perforation are old degenerated graft, ulcerated plaque, severe fibrotic, or calcified lesion necessitating high pressure balloon or stent inflation, use of intravascular ultrasound (IVUS) or other atheroablative devices. Management includes prolonged balloon occlusion, reversal of anticoagulation, use of covered stent, and emergency pericadiocentesis if required.
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Deora et al. (2015) conducted a case report in Saphenous vein graft perforation during PCI (n=1). Covered stent was evaluated on Sealing of perforation and clinical outcome. A saphenous vein graft perforation during percutaneous coronary intervention was successfully managed with a covered stent, resulting in complete sealing and an asymptomatic patient at 1 month.
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