title: Percutaneous intervention of a thrombotic-occluded saphenous vein graft successfully treated using the undersized stent approach to prevent distal embolization.
abstract: Percutaneous intervention carries a higher risk of distal embolization and poorer outcome in saphenous vein grafts (SVG) than in native coronary vessels. Embolic protection devices (EPD) have demonstrated value in decreasing the risk of embolization and post-procedural enzymes elevation after SVG intervention. Although there is ample evidence to support the routine use of EPD for SVG interventions, frequently those devices are not utilized or cannot be used because of technical reasons. As we previously reported, the "undersized stenting" approach seems to be an attractive strategy when EPD cannot be used. We present a case with severe SVG degeneration that illustrates the feasibility of this strategy.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Maluenda
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfonso
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D054855:Drug-Eluting Stents; D004617:Embolism / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D000068338:Everolimus; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000637:transplantation*; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D002317:Cardiovascular Agents; D000068338:Everolimus; D020123:Sirolimus