Primary percutaneous coronary intervention in saphenous vein grafts: a visualization strategy to improve outcome with new uses for the aspiration catheter.
Primary percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) is often a high-risk procedure associated with poor short- and long-term outcomes. Venous grafts frequently supply a clinically important myocardial territory. These vessels, however, combine the problems of a less predictable course and run-off as compared to native vessels with the presence of severe degenerative atherosclerosis. These factors amplify the risk due to an increased chance of distal embolization and no-reflow. We present three different situations during primary PCI in SVGs where a thrombosuction catheter was utilized to visualize the problem and then apply therapeutic maneuvers that proved crucial in achieving a successful result.
Patterson
Mark S
MS
Academic Department of Interventional Cardiology, OLVG, Amsterdam, The Netherlands. markspatterson@doctors.net.uk
Ghuran
Azad
A
Laarman
Gert Jan
GJ
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy*; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation; D008875:Middle Aged; D012501:Saphenous Vein / Q000637:transplantation*; D013396:Suction