From Myocardial Infarction to Peripheral Stenting

Abstract

Degenerated saphenous vein grafts (SVGs) are associated with high risk of myocardial infarction (MI). They are difficult to treat percutaneously because of large variability in their wall diameters. We report a case of a 71-year-old male, who presented with an acute inferior ST elevation MI (STEMI) 16 years following revascularization with triple coronary artery bypass graft (sequential SVG to the posterior interventricular and to the second marginal branch of the left circumflex artery, and left internal mammal artery to the left anterior descending). Coronary angiography revealed a massive thrombotic occlusion of the second part of the sequential graft, which was aneurysmal just after the posterior interventricular artery. Thromboaspiration was performed and revealed an 8 mm diameter aneurysmal degenerated graft. We decided to use a balloon-expandable peripheral stent to treat this lesion. TIMI 3 outflow was restored without any no-reflow phenomenon. Patient was discharged to his origin hospital 3 days later. He had an uneventful evolution at the 3 months follow-up. J Med Cases. 2016;7(4):133-135 doi: http://dx.doi.org/10.14740/jmc2451w