Aspiration of a mobile thromboembolus from saphenous vein graft

An 81-year-old woman who was 4 years post 3-vessel coronary artery bypass graft (CABG) surgery suffered a non-Q-wave myocardial infarction. Angiography revealed the recent occlusion of a saphenous vein graft (SVG) to an obtuse marginal coronary artery. Five days following failure of intragraft urokinase and systemic heparinization to recanalize the SVG, balloon angioplasty was undertaken. A mobile thrombus was observed to migrate spontaneously in a retrograde manner in the SVG and was removed during PTCA by aspiration through the guiding catheter.