Rheolytic thrombectomy with distal filter embolic protection as adjunctive therapies to high-risk saphenous vein graft intervention.
Percutaneous intervention of saphenous vein graft (SVG), especially those with heavy atherothrombotic load, presents high risk for distal embolization and no-reflow. Using the distal filters alone may occasionally be disadvantageous because of the large debris burden and the inability to assess the underlying culprit lesions and vessel size accurately. We present a case of intervention of an occluded SVG using a combination of rheolytic thrombectomy and distal filter embolic protection as a pretreatment before stenting. This strategy has the potential to reduce further the risk of no-reflow and to provide visualization for proper assessment of the underlying anatomy especially in clot-laden vessels.
Ho
Paul C
PC
Division of Cardiology, Kaiser Foundation Hospital, Honolulu, Hawaii. paul.c.ho@kp.org
Leung
Cyril Y
CY
D021721:Balloon Occlusion; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D005374:Filtration / Q000295:instrumentation; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein / Q000000981:diagnostic imaging* / Q000637:transplantation; D017131:Thrombectomy / Q000379:methods*