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Intracoronary stent placement in thrombus containing vein graft lesions
1Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
Insights
Intracoronary stents are now viable for complex lesions with thrombus. Recent techniques reduce stent thrombosis risk, enabling successful stenting in saphenous vein grafts, even with existing clots.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- Intracoronary stents traditionally contraindicated with thrombus.
- Advances in stent deployment reduce stent thrombosis risk.
Observation:
- A case of successful stent placement in a thrombus-laden saphenous vein graft to the posterior descending artery is reported.
- The stented graft remained patent three months post-procedure.
Findings:
- The study demonstrates the feasibility and safety of intracoronary stenting in a saphenous vein graft containing intraluminal thrombus.
- Successful stent placement was confirmed by patency at three-month follow-up.
Implications:
- Intracoronary stenting should be considered for complex coronary artery lesions, even when intraluminal thrombus is present.
- This approach may offer a viable treatment option for patients with challenging graft stenosis and thrombus.
Abstract:
Intracoronary stents are traditionally considered to be contraindicated in presence of thrombus. However recent advances in stent deployment technique have reduced the risk of stent thrombosis. We report the placement of a stent in a thrombus laden saphenous vein graft to the posterior descending artery. Three months later the stent site was patent with severe stenosis with thrombus in another graft which was also stented. Intracoronary stents should be considered in patients with complex lesion even in presence of intraluminal thrombus.