Hemoptysis caused by saphenous vein graft perforation during percutaneous coronary intervention

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Surgery

Background:

• Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
• Coronary artery perforation is a known, albeit infrequent, complication of PCI.
• Saphenous vein graft (SVG) rupture is a rare but potentially catastrophic complication during PCI.

Observation:

• A patient undergoing PCI experienced immediate hemoptysis following a saphenous vein graft rupture.
• The hemoptysis was directly linked to the SVG rupture, a rare presentation.
• Standard management protocols for coronary artery perforation were considered.

Findings:

• A covered stent was deployed to seal the saphenous vein graft perforation.
• Protamine sulfate was administered concurrently to manage anticoagulation.
• The combined intervention successfully occluded the perforation and resolved the hemoptysis.

Implications:

• This case highlights a rare complication of PCI involving SVG rupture and hemoptysis.
• Covered stent technology offers a viable solution for managing complex graft perforations.
• Simultaneous use of protamine may be beneficial in managing such acute complications during PCI.