Intravascular Lithotripsy-Assisted Percutaneous Coronary Intervention of Vein Graft In-Stent Calcified Restenosis

Area of Science:

• Cardiovascular Interventions
• Interventional Cardiology
• Vascular Surgery

Background:

• Saphenous vein grafts exhibit lower patency rates than native or arterial bypass grafts.
• Percutaneous coronary intervention (PCI) is frequently used for graft failure due to high risks associated with repeat bypass surgery.
• PCI in saphenous vein grafts has a high rate of stent failure, yet remains necessary for refractory angina.

Observation:

• This case study explores the use of intravascular lithotripsy (IVL) as an adjunctive therapy for PCI.
• The focus is on treating severe calcified in-stent restenosis within a saphenous vein graft.
• Intravascular imaging was crucial for managing this complex, high-risk PCI.

Findings:

• Intravascular lithotripsy was demonstrated to be safe and feasible as an adjunct to PCI.
• Successful treatment of severe calcified in-stent restenosis in a saphenous vein graft was achieved.
• The study highlights the critical role of intravascular imaging in complex PCI procedures.

Implications:

• Intravascular lithotripsy may offer a viable solution for challenging saphenous vein graft restenosis.
• Enhanced visualization with intravascular imaging improves outcomes in complex coronary interventions.
• This approach could expand treatment options for patients with refractory angina and failing vein grafts.