Successful treatment of a huge thrombotic saphenous vein graft occlusion with aspiration thrombectomy: A case report


Akcay M.

Journal of Tehran University Heart Center, vol.15, no.2, pp.69-72, 2020 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 15 Issue: 2
  • Publication Date: 2020
  • Journal Name: Journal of Tehran University Heart Center
  • Journal Indexes: Scopus, Academic Search Premier, Agricultural & Environmental Science Database, Biotechnology Research Abstracts, CAB Abstracts, CINAHL, EMBASE
  • Page Numbers: pp.69-72
  • Keywords: Saphenous vein, Thrombectomy, Thrombosis
  • Ondokuz Mayıs University Affiliated: Yes

Abstract

Saphenous vein grafts (SVGs) are widely used conduits for the surgical revascularization of coronary arteries, but they are associated with poor long-term patency rates. Acute SVG thromboses often present as acute coronary syndrome and have an extensive atherosclerotic and thrombotic burden. Percutaneous coronary intervention (PCI) is the first treatment option; however, it carries a high risk of distal embolization, no-reflow, and periprocedural myocardial infarction. Reducing the thrombus burden and preventing distal embolization during PCI can be achieved by using some pharmacological strategies (e.g., glycoprotein IIb/IIIa antagonists) and devices (e.g., thrombectomy and filter devices). There are yet no better therapeutic options for patients undergoing PCI of SVG occlusions. Here, we introduce a 52-year-old male patient admitted with a typical acute chest pain of 1 hour’s duration. Electrocardiography showed signs of acute inferoposterior myocardial infarction. A thrombotic SVG occlusion was detected in primary PCI, and a huge thrombus content was aspirated. After the thrombus aspiration with stent implantation, the chest pain was relieved and the ST-segment elevation was improved. The patient has been followed without any symptoms for 10 months.