Effect of abciximab on cardiac enzyme elevation after transluminal extraction atherectomy (TEC) in high-risk saphenous vein graft lesions: comparison with a historical control group

Distal occluder and rheolytic thrombectomy of a saphenous vein graft lesion with a large associated thrombus

Percutaneous intervention in thrombus-containing lesions is frequently associated with complications, including distal embolization and no-reflow. In saphenous vein bypass grafts (SVG), friable atheroma and associated thrombus make interventions particularly difficult. Distal protection strategies are in development, but complete protection with removal of all potentially embolic material is challenging. This case illustrates a novel technique using a distal occluder balloon and rheolytic thrombectomy followed by stent deployment to treat a SVG lesion. This combination therapy was technically feasible, resulted in no angiographic complications and normal creatine kinase levels throughout follow-up, and can be used during high risk SVG interventions.

Percutaneous intervention for atherosclerotic disease in saphenous vein grafts

The long term benefit of coronary artery bypass surgery (CABG) is limited by development of atherosclerotic disease in the bypass conduits. Percutaneous revascularisation is frequently the preferred method of treated symptomatic saphenous vein graft (SVG) atherosclerotic disease. The immediate and long term results of percutaneous intervention for SVGs is reviewed. Therapeutic considerations as well as novel technical advances are overviewed