Orbital Atherectomy and Heavily Calcified Saphenous Vein Graft Intervention

Texas Heart Institute Journal
Maheedhar GedelaTomasz Stys

Abstract

Percutaneous coronary intervention in the diseased saphenous vein graft differs significantly from that in the diseased native coronary artery. After being exposed to arterial pressures over time, vein grafts have substantially different plaque characteristics, with more inflammatory cells, more diffuse disease, and less calcification. Severe calcification of saphenous vein grafts, although uncommon, poses a high risk of stent underexpansion. Orbital atherectomy for treatment of de novo calcified coronary lesions has been associated with better outcomes at 5-year follow-up. However, there are no published data on the use of orbital atherectomy to treat severely calcified saphenous vein graft lesions. We present the case of a 77-year-old woman with non-ST-segment-elevation myocardial infarction who underwent successful orbital atherectomy to prepare a severely calcified saphenous vein graft lesion for stent implantation.

References

Dec 18, 2001·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·S SdringolaR W Smalling
Aug 20, 2011·JACC. Cardiovascular Interventions·Michael S LeeGregg W Stone
Mar 6, 2013·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Keyur ParikhJeffrey Chambers
Apr 14, 2015·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Parloop BhattKeyur Parikh
Feb 7, 2017·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Michael LeeJeff W Chambers
Nov 1, 2017·Circulation·Mario GaudinoUNKNOWN ATLANTIC (Arterial Grafting International Consortium) Alliance

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