Percutaneous revascularization of an extensively diseased saphenous vein bypass graft with a saphenous vein-covered Palmaz stent.

A 68-year-old man developed unstable angina 12 years following coronary artery bypass surgery. Angiography revealed an extensive area of severe stenosis and diminished distal flow in a right coronary artery vein bypass graft. Given the high distal embolism rate associated with conventional catheter-based treatment of old degenerated vein grafts, the diseased area was "relined" with a composite autologous saphenous vein-covered stent. The procedure was performed using modifications of standard PTCA methods and resulted in a widely patent, smooth lumen. This initial case demonstrates that a degenerated saphenous vein graft can be successfully revascularized with an autologous saphenous vein-covered stent in an attempt to minimize the potential complications of standard catheter-based revascularization methods.

Duke Scholars

Author Paul Alfred Gurbel Medicine, Clinical Pharmacology