Endoluminal Grafting for Percutaneous Aneurysm Exclusion in an Aortocoronary Saphenous Vein Graft: The First Clinical Experience

Abstract

In this patient with limited therapeutic options, percutaneous aneurysm exclusion in an SVG was effective in restoring a viable blood conduit. It remains to be seen if ELGs have a potential in aortocoronary SVGs.

Fracture of coronary guidewire during rotational atherectomy with coronary perforation and tamponade

“…In the report by Ellis and colleagues [6], it is suggested that class-3 perforations with free extravasation of dye and early tamponade should all be managed operatively. Recently, the use of autologous saphenous vein grafts sewn to stents has been reported to be effective in sealing perforations [7,8], while we have reported the successful implantation of an endoluminal graft composed of expanded polytetrafluoroethylene sewn to a Palmaz stent in a similar application [9].…”

Obliteration of a Coronary Artery Aneurysm With a PTFE-Covered Stent: Endoluminal Graft for Coronary Disease Revisited

“…In our case the CAA was wide in diameter and long in length, and we felt that a covered stent would be more appropriate. In addition, IVUS [14,15] may have been useful in this setting to define whether this was a true aneurysm or pseudoaneurysm; however, with the increasing size of the aneurysm, symptoms, and documentation of ischemia, treatment would have still been necessary. Other options for CAA include coronary artery bypass surgery (CABG) with aneurysm resection [16]; however, with singlevessel coronary disease, we preferred to treat this nonsurgically.…”

Covered stents: A 25‐year odyssey

“…We first introduced the concept of the polytetrafluoroethylene (PTFE)‐covered stent in Phoenix 25 years ago. In 1993, we successfully treated a complex aneurysmal lesion in a saphenous vein graft, which was causing ischemic symptoms, by creating a mechanical barrier to seal the aneurysm by preparing the stent graft with commercially available PTFE, and a commercially available Palmaz stent . Dr. Christodoulos Stefanadis also designed the application of a biological covered stent in which the metallic surface was covered by an autologous venous graft .…”